Reduction in all-cause medical and caregiving costs through innovative health awareness projects in a rural area in Japan: a retrospective cohort study

• Published in: BMC health services research Vol. 24; no. 1; p. 370
• Main Authors: Shoji, Ayako, Kudo, Kennichi, Murashita, Koichi, Nakaji, Shigeyuki, Igarashi, Ataru
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 25.03.2024; BioMed Central; BMC
• Subjects: Analysis; Blood pressure; Blood tests; Caregivers; Caregiving costs; Cohort analysis; Coronary heart disease; Costs; Cross-Sectional Studies; Data linkage; Economic aspects; Evaluation; Health care expenditures; Health insurance; Health program; Health promotion; Health Promotion - methods; Humans; Japan; Life expectancy; Lifestyles; Local government; Medical care, Cost of; Medical costs; Medical research; Medicine, Experimental; Public health administration; Retrospective Studies; Risk Factors; Rural area; Rural areas; Stroke; Walking; Japan; Caregiving costs; Rural area; Health program; Medical costs; Data linkage
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-024-10836-0

This study evaluates cost reduction in participants of a health awareness program (the Center of Healthy Aging Program, CHAP) in a Japanese rural area, characterized by an annual check-up and personalized interview on health issues and related risks immediately after the check-up. This is a cross-sectional study using medical and caregiving costs and Japan-specific health check-up results in Hirosaki residents stored by the local government, which were individually-based linked to the CHAP information collected by Hirosaki University. This is the first study that used anonymized data with individually-based linkages to both a research institute and a local government in Japan under a strict limitation regarding linking to third-party data. We included residents who had been continuously enrolled for > 6 months as of 1 July 2015. We compared 5-year all-cause costs between three groups (with CHAP, with Japan-specific health check-up, and no check-up) using a multivariate negative binomial regression model considering risk factors including lifestyle habits and an inverse probability weight to adjust for baseline characteristics: age, sex, Charlson comorbidity index, baseline care level, and risk score of coronary heart diseases. A total of 384, 9805, and 32,630 residents aged 40-74 years were included for the CHAP, Japan-specific health check-up, and no check-up groups, respectively. The Japan-specific health check-up group showed older and higher Charlson comorbidity index than the others. After inverse probability weight adjusting, the amount of all-cause medical costs was significantly lower only in the CHAP group. Faster walking speed and exercise habits were independently associated with lower all-cause medical and caregiving costs. We demonstrated a 5-year all-cause cost reduction in residents who participated in the CHAP and also suggested the effect of exercise habits in Hirosaki, which indicated the significance of individually-based data linkages to external third-party data for all local governments to improve the health condition of residents.