An Out-of-Pocket Cost Removal Intervention on Fecal Occult Blood Test Attendance

Takahiro Tabuchi, Hiroshi Murayama, Takahiro Hoshino, Tomio Nakayama

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: To date, no comparative study has assessed the impact of a cost-removal intervention on fecal occult blood testing (FOBT). In 2012, the Japanese government introduced a nationwide project to remove out-of-pocket costs for FOBT. The study objective was to evaluate the differential impact of the intervention on FOBT attendance in the total population and various subgroups. Methods: This study analyzed 309,103 people in national, repeated cross-sectional studies, observed pre- and post-intervention (2010 and 2013), using covariate-adjusted difference-in-differences estimates to compare intervention and no-intervention groups. The outcome measure was uptake of FOBT attendance resulting from the intervention. Stratified analyses were conducted according to sociodemographic and health-related characteristics. Results: The intervention was associated with significantly positive uptake of FOBT in both genders, but the impact was greater in women than men: 6.7% (95% CI=5.2, 8.1) for women and 2.7% (95% CI=1.1, 4.3) for men in the covariate-adjusted models. Post-intervention, attendance increased in almost all subgroups in women. However, among men, some socially advantaged subgroups, such as high expenditure, high education, and public officers, showed no effect. Some subgroups such as current smokers and less than high school education were identified as hard-to-reach populations that may be less sensitive to the intervention, irrespective of gender. Conclusions: This is the first comparative study of cost-removal intervention for uptake of FOBT. The intervention may increase FOBT attendance. However, the size of the effect is not great, especially in men, and differential effects occurred across subgroups including gender and socioeconomic differences.

Original languageEnglish
JournalAmerican Journal of Preventive Medicine
DOIs
Publication statusAccepted/In press - 2017

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Occult Blood
Hematologic Tests
Health Expenditures
Education
Costs and Cost Analysis
Population
Cross-Sectional Studies
Outcome Assessment (Health Care)
Health

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

An Out-of-Pocket Cost Removal Intervention on Fecal Occult Blood Test Attendance. / Tabuchi, Takahiro; Murayama, Hiroshi; Hoshino, Takahiro; Nakayama, Tomio.

In: American Journal of Preventive Medicine, 2017.

Research output: Contribution to journalArticle

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