Elderly Population Projection and Their Health Expenditure Prospects in Japan

Fukawa, Tetsuo

doi:10.4236/me.2017.811085

Cited by 14 publications

(12 citation statements)

References 7 publications

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“…This study does not include vital signs or laboratory measurements, which could add context to the systemic symptoms that can be present in patients with GPP or plaque psoriasis. In the MDV database, approximately 45% of the population is aged ≥65 years, compared with 26.6% of the overall population in Japan (as the population was in 2015), 24 which may affect the generalizability of the study. Also, the average age of those with GPP within the MDV database is higher than the epidemiologic data of patients with GPP in Asia suggests (i.e.…”

Section: Discussionmentioning

confidence: 99%

Patient characteristics and burden of disease in Japanese patients with generalized pustular psoriasis: Results from the Medical Data Vision claims database

Morita

Kotowsky

Gao

et al. 2021

The Journal of Dermatology

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Generalized pustular psoriasis (GPP) is a rare, severe, neutrophilic skin disease characterized by episodes of widespread eruption of sterile, visible pustules, which can occur with or without systemic inflammation and with or without plaque psoriasis. 1,2 GPP is associated with potentially life-threatening systemic complications including sepsis and cardiac failure, and is described by the Japan Ministry of Health as an intractable disease. [1][2][3][4] Mutations in IL36RN, CARD14, or AP1S3 have been found in patients with GPP. 5,6 Small Japanese studies have identified a number of different IL36RN mutations in patients with GPP. [7][8][9] Patients with these mutations may be at risk of earlier onset of disease and more severe disease. 10 Indeed, one small study (n = 31 patients with GPP)

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Section: Discussionmentioning

confidence: 99%

Patient characteristics and burden of disease in Japanese patients with generalized pustular psoriasis: Results from the Medical Data Vision claims database

Morita

Kotowsky

Gao

et al. 2021

The Journal of Dermatology

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“…In Japan, the annual medical expenditures in 2016 were approximately ¥42.1 trillion (approximately US$372 billion per the 2016 exchange rate) [2, 3], and the annual long-term care (LTC) expenditures in 2016 were approximately ¥10.0 trillion (approximately US$88 billion) [4]. These expenditures are projected to further increase with a rapidly aging society, as is the case with many OECD countries [1, 5]. Therefore, it is essential to identify the factors associated with the increase in these expenditures to develop strategies to ensure sustainable medical and LTC systems.…”

Section: Introductionmentioning

confidence: 99%

The associations of multimorbidity with the sum of annual medical and long-term care expenditures in Japan

et al. 2019

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Background The occurrence of multimorbidity (i.e., the coexistence of multiple chronic diseases) increases with age in older adults and is a growing concern worldwide. Multimorbidity has been reported to be a driving factor in the increase of medical expenditures in OECD countries. However, to the best of our knowledge, there is no published research that has examined the associations between multimorbidity and either long-term care (LTC) expenditure or the sum of medical and LTC expenditures worldwide. We, therefore, aimed to examine the associations of multimorbidity with the sum of medical and LTC expenditures for older adults in Japan. Methods Medical insurance claims data for adults ≥75 years were merged with LTC insurance claims data from Kashiwa city, a suburb in the Tokyo metropolitan area, for the period between April 2012 and September 2013 to obtain an estimate of medical and LTC expenditures. We also calculated the 2011 updated and reweighted version of the Charlson Comorbidity Index (CCI) scores. Then, we performed multiple generalized linear regressions to examine the associations of CCI scores (0, 1, 2, 3, 4, or ≥ 5) with the sum of annual medical and LTC expenditures, adjusting for age, sex, and household income level. Results The mean sum of annual medical and LTC expenditures was ¥1,086,000 (US$12,340; n = 30,042). Medical and LTC expenditures accounted for 66 and 34% of the sum, respectively. Every increase in one unit of the CCI scores was associated with a ¥257,000 (US$2920); 95% Confidence Interval: ¥242,000, 271,000 (US$2750, 3080) increase in the sum of the expenditures ( p < 0.001; n = 29,915). Conclusions Using a merged medical and LTC claims dataset, we found that greater CCI scores were associated with a higher sum of annual medical and LTC expenditures for older adults. To the best of our knowledge, this is the first study to examine the associations of multimorbidity with LTC expenditures or the sum of medical and LTC expenditures worldwide. Our study indicated that the economic burden on society caused by multimorbidity could be better evaluated by the sum of medical and LTC expenditures, rather than medical expenditures alone. Electronic supplementary material The online version of this article (10.1186/s12877-019-1057-7) contains supplementary material, which is available to authorized users.

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“…If only limited data can be available, it is also possible to develop a prediction model with certain accuracy by reducing the explanatory variables: the variable importance plot showed Furthermore, the present results have policy implications. Although the Japanese healthcare system has achieved high service quality with fairly low health expenditure [33], national health expenditure increases aggressively every year [34]. As proposed in the concept of "data health" by the Ministry of Health, Labour and Welfare (MHLW), 9 an effective and efficient promotion of healthcare programs using predictive analytics is of great importance in the field of public health.…”

Section: Discussionmentioning

confidence: 99%

Identifying the Most Appropriate Intervention Targets Using Prediction Model Based on a Machine-Learning Method: A Retrospective Analysis of a Health Promotion Program for Improving Participation in General Health Check-Up

Shimoda¹,

Saito²,

Ooe³

et al. 2018

ejbi

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Objective: We aimed to identify the population in which encouraging participation in the general health checkup would be helpful using a prediction model based on a machine-learning method. A secondary analysis of data obtained from the health promotion program using a randomized controlled design, aimed at improving participation in the general health checkup , was performed. Methods: The retrospective analysis was conducted using data from a health promotion program in the Fukuoka branch of Japan Health Insurance Association, Japan, between November 2015 and March 2016. Subjects were extracted from dependents (family members) of insured persons aged 40-74 years who had participated in general health checkup at least once in the past five years (2010-2014). Subjects were divided into two groups; the intervention group received a printed reminder saying "you are due to general health check-up" through mail, while the control group received nothing. The participation rates of both groups for each participation probability group (participation probability was calculated by the prediction model) were assessed after 4 month follow-up. Results: The numbers in the intervention group and in the control group were 1,911 and 3,294, respectively. Regarding the prediction model, the AUC value for test data was 0.668 (95%CI: 0.635-0.701). With regard to the effectiveness of the intervention for each probability group, there was a significant difference between the groups only for the moderate participation probability groups as follows: 30-39% (P=0.005), 40-49% (P=0.003), 50-59% (P=0.004) and 60-69% (P=0.039). Conclusion: The intervention with printed reminder was effective for improving participation of general health checkup among the group with moderate participation probability. The targeting using the results of prediction model was useful for identifying appropriate intervention targets. Conclusions: More studies are needed to assess the cost and benefits of adopting a system like this and then the appropriate actions could be taken.

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Elderly Population Projection and Their Health Expenditure Prospects in Japan

Cited by 14 publications

References 7 publications

Patient characteristics and burden of disease in Japanese patients with generalized pustular psoriasis: Results from the Medical Data Vision claims database

Patient characteristics and burden of disease in Japanese patients with generalized pustular psoriasis: Results from the Medical Data Vision claims database

The associations of multimorbidity with the sum of annual medical and long-term care expenditures in Japan

Identifying the Most Appropriate Intervention Targets Using Prediction Model Based on a Machine-Learning Method: A Retrospective Analysis of a Health Promotion Program for Improving Participation in General Health Check-Up

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