Medical costs of patients with hypertension and/or diabetes: a 10-year follow-up study of National Health Insurance in Shiga, Japan

Nakamura, Koshi; Okamura, Tomonori; Kanda, Hideyuki; Hayakawa, Takehito; Okayama, Akira; Ueshima, Hirotsugu

doi:10.1097/01.hjh.0000249711.28769.80

Cited by 13 publications

(10 citation statements)

References 19 publications

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“…Furthermore, participants with multiple diseases incurred higher medical costs over a long duration than those without or having only 1 disease [45]. Therefore, the financial situations of low-income individuals would go from bad to worse in the presence of illness.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Non-Communicable Diseases and Number of Comorbidities According to Differences in Household Income Levels in Japan: Analysis from National Health and Nutrition Survey

Horikawa¹,

Murayama²,

Ota³

et al. 2017

FNS

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Though it has been reported that in Western developed countries socioeconomic status is associated with non-communicable diseases (NCD), there are sparse evidence from Japan, midst an income gap that has been pointed out in recent years. Therefore, we examined the presence or absence of NCD and the number of comorbidities according to household income in Japanese, using data from the National Health and Nutrition Survey of 2010. 1287 men and 1659 women aged 20 -79 years from households at 3 income levels (<2, 2 -5.9, ≥6 million yen) were analyzed. Participants completed questionnaires regarding whether they had been diagnosed with NCD, as well as undergoing clinical laboratory tests. Logistic regression analyses were used for statistical analysis with adjustment for age, gender, household size, and population of municipalities. The prevalences of participants with high, medium, and low income were 22.3%, 57.6%, and 20.2%, respectively. Participants with the lowest income had the highest odds of hypertension (OR [95% confidence interval or 3 NCD (hypertension, diabetes, and hypercholesterolemia) were 15.0% and 33.0% in high and low income levels, respectively. A low income could contribute to a high prevalence of NCD and large number of comorbidities among Japanese. Establishing a health policy in Japan is needed to enable an optimal health condition and lifestyle regardless of socioeconomic disparities.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Non-Communicable Diseases and Number of Comorbidities According to Differences in Household Income Levels in Japan: Analysis from National Health and Nutrition Survey

Horikawa¹,

Murayama²,

Ota³

et al. 2017

FNS

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“…A 10-yr follow-up study in Japan reported that medical costs for subjects with a self-reported history of diabetes were approximately 2-fold higher than those for subjects without either hypertension or diabetes 7) . Even with a shorter follow-up period, our results indicated that the medical costs for subjects with known diabetes were 3.3-fold higher than those for the non-diabetic group.…”

Section: Discussionmentioning

confidence: 99%

“…In a study of communitydwelling Japanese individuals with hypertension and/or diabetes over a 10-yr period, Nakamura et al reported that people with diabetes alone and those with both hypertension and diabetes had 2.3-and 2.4-fold higher personal medical expenditures, respectively, compared with people who had neither disorder. However, some true cases of diabetes may have been misclassified in that study because diabetes cases were only identified by a known history of diabetes 7) .…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, the economic burdens of diabetes and its complications are mounting. Although many studies have reported excess medical costs for individuals with diabetes [2][3][4][5][6][7][8] , relatively few studies have focused on working-age populations. The medical and productivity costs for employees with diabetes were reported to be 2.5-fold higher than those for control subjects in patients aged 46-55 yr 2) .…”

Section: Introductionmentioning

confidence: 99%

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Relationships between Diabetes and Medical and Dental Care Costs: Findings from a Worksite Cohort Study in Japan

Ide¹,

Hoshuyama²,

Wilson

et al. 2010

Ind Health

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The purpose of this study was to evaluate the relationships between diabetes and medical and dental care costs from a 5-yr prospective observation of Japanese workers. The data were derived from health and dental examinations and health insurance claims of 4,086 workers aged 40-54 yr. At baseline, the subjects were assigned to four categories: known diabetes; undiagnosed diabetes; impaired fasting glucose (IFG); and non-diabetic. The differences in health care costs among the non-diabetics, IFG and undiagnosed diabetes groups were not seen at baseline, but the costs incurred by the subjects with undiagnosed diabetes substantially increased thereafter. Over 5 yr of the study period, compared with the non-diabetic group, subjects with known diabetes incurred 3.9-and 2.9-fold higher annual inpatient and outpatient costs, respectively, while subjects in the undiagnosed diabetes group incurred 3.0-and 1.6-fold higher costs, respectively. There were no significant associations between annual dental care costs and diabetic status. The excess costs of medical care among subjects with diabetes were attributable to diabetes itself, heart disease and cerebrovascular disease, but not cancer. Among middle-aged workers, diabetics incurred significantly greater medical care costs than non-diabetics, whereas IFG was not associated with higher costs.

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“…The details of the present cohort have been reported previously. 25,[31][32][33] In brief, the study participants, aged 40-69 years, lived in seven rural towns and a village in Shiga Prefecture, West Japan, and had a voluntary baseline survey in 1989-1991. In 1990, the study area had 82 155 residents, including 31 564 individuals aged 40-69 years, of whom 11 900 were NHI beneficiaries.…”

Section: Study Design and Participantsmentioning

confidence: 99%

Medical expenditures of men with hypertension and/or a smoking habit: a 10-year follow-up study of National Health Insurance in Shiga, Japan

et al. 2010

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Hypertension and smoking are major causes of disability and death, especially in the Asia-Pacific region, where there is a high prevalence of a combination of these two risk factors. We attempted to measure the medical expenditures of a Japanese male population with hypertension and/or a smoking habit over a 10-year period of follow-up. A cohort study was conducted that investigated the medical expenditures due to a smoking habit and/or hypertension during the decade of the 1990s using existing data on physical status and medical expenditures. The participants included 1708 community-dwelling Japanese men, aged 40-69 years, who were classified into the following four categories: 'neither smoking habit nor hypertension', 'smoking habit alone', 'hypertension alone' or 'both smoking habit and hypertension.' Hypertension was defined as a systolic blood pressure of X140 mm Hg, a diastolic blood pressure of X90 mm Hg or taking antihypertensive medications. In the study cohort, 24.9% had both a smoking habit and hypertension. During the 10-year follow-up period, participants with a smoking habit alone (18 444 Japanese yen per month), those with hypertension alone (21 252 yen per month) and those with both a smoking habit and hypertension (31 037 yen per month) had increased personal medical expenditures compared with those without a smoking habit and hypertension (17 418 yen per month). Similar differences were observed even after adjustment for other confounding factors (Po0.01). Japanese men with both a smoking habit and hypertension incurred higher medical expenditures compared with those without a smoking habit, hypertension or their combination.

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Medical costs of patients with hypertension and/or diabetes: a 10-year follow-up study of National Health Insurance in Shiga, Japan

Cited by 13 publications

References 19 publications

Prevalence of Non-Communicable Diseases and Number of Comorbidities According to Differences in Household Income Levels in Japan: Analysis from National Health and Nutrition Survey

Prevalence of Non-Communicable Diseases and Number of Comorbidities According to Differences in Household Income Levels in Japan: Analysis from National Health and Nutrition Survey

Relationships between Diabetes and Medical and Dental Care Costs: Findings from a Worksite Cohort Study in Japan

Medical expenditures of men with hypertension and/or a smoking habit: a 10-year follow-up study of National Health Insurance in Shiga, Japan

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