[Effect of cardiovascular risk factors on individual and population medical expenditures

a 10-year cohort study of 4,535 National Health Insurance beneficiaries in Shiga].

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

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

A 10-year follow-up cohort study of 4,535 National Health Insurance beneficiaries aged 40 to 69 years in Shiga was performed as part of a research project conducted by the Health Promotion Research Committee of the Shiga National Health Insurance Organizations in 2002. The relationship between cardiovascular risk factors and medical expenditures during the 10-year study period has been examined in this cohort. For example, there was a positively graded correlation between blood pressure and individual total medical expenditures per month. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensives were also higher than those in normotensives. However, from the viewpoint of the entire population, the excess medical expenditures attributable to hypertension within the total medical expenditures were higher for mild-to-moderate hypertensives than for severe hypertensives. On the other hand, although individual medical expenditures per month were 1.7-fold higher for participants with 2 or 3 risk factors and obesity, which was broadly equivalent to metabolic syndrome, than for those without these factors, the excess medical expenditures determined by risk clustering within the total medical expenditures were higher in normal-weight people than in obese people because of the higher prevalence of normal weight. These findings suggest that high-risk individuals are a good target of a high-risk approach, such as intensive health guidance, from the viewpoint of medical expenditures. However, another approach for the majority with a low-to-moderate cardiovascular risk should be considered, because they account for a greater proportion of the excess medical expenditures. Another way to solve this problem may be a population approach with an effective method of providing information to citizens.

Original languageEnglish
Pages (from-to)38-43
Number of pages6
JournalNihon eiseigaku zasshi. Japanese journal of hygiene
Volume67
Issue number1
DOIs
Publication statusPublished - 2012 Jan

Fingerprint

National Health Programs
Insurance Benefits
Health Expenditures
Cohort Studies
Population
Metabolic Equivalent
Weights and Measures
Health Promotion
Research
Cluster Analysis
Hospitalization
Obesity
Odds Ratio
Organizations
Blood Pressure
Hypertension
Mortality
Health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

[Effect of cardiovascular risk factors on individual and population medical expenditures : a 10-year cohort study of 4,535 National Health Insurance beneficiaries in Shiga]. / Okamura, Tomonori; Nakamura, Koshi; Hayakawa, Takehito; Kanda, Hideyuki; Miura, Katsuyuki; Okayama, Akira; Ueshima, Hirotsugu.

In: Nihon eiseigaku zasshi. Japanese journal of hygiene, Vol. 67, No. 1, 01.2012, p. 38-43.

Research output: Contribution to journalArticle

@article{f67a0b0fde734e6fbf70105e0cb18eb4,
title = "[Effect of cardiovascular risk factors on individual and population medical expenditures: a 10-year cohort study of 4,535 National Health Insurance beneficiaries in Shiga].",
abstract = "A 10-year follow-up cohort study of 4,535 National Health Insurance beneficiaries aged 40 to 69 years in Shiga was performed as part of a research project conducted by the Health Promotion Research Committee of the Shiga National Health Insurance Organizations in 2002. The relationship between cardiovascular risk factors and medical expenditures during the 10-year study period has been examined in this cohort. For example, there was a positively graded correlation between blood pressure and individual total medical expenditures per month. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensives were also higher than those in normotensives. However, from the viewpoint of the entire population, the excess medical expenditures attributable to hypertension within the total medical expenditures were higher for mild-to-moderate hypertensives than for severe hypertensives. On the other hand, although individual medical expenditures per month were 1.7-fold higher for participants with 2 or 3 risk factors and obesity, which was broadly equivalent to metabolic syndrome, than for those without these factors, the excess medical expenditures determined by risk clustering within the total medical expenditures were higher in normal-weight people than in obese people because of the higher prevalence of normal weight. These findings suggest that high-risk individuals are a good target of a high-risk approach, such as intensive health guidance, from the viewpoint of medical expenditures. However, another approach for the majority with a low-to-moderate cardiovascular risk should be considered, because they account for a greater proportion of the excess medical expenditures. Another way to solve this problem may be a population approach with an effective method of providing information to citizens.",
author = "Tomonori Okamura and Koshi Nakamura and Takehito Hayakawa and Hideyuki Kanda and Katsuyuki Miura and Akira Okayama and Hirotsugu Ueshima",
year = "2012",
month = "1",
doi = "10.1265/jjh.67.38",
language = "English",
volume = "67",
pages = "38--43",
journal = "Nihon eiseigaku zasshi. Japanese journal of hygiene",
issn = "0021-5082",
publisher = "Japanese Society for Hygiene",
number = "1",

}

TY - JOUR

T1 - [Effect of cardiovascular risk factors on individual and population medical expenditures

T2 - a 10-year cohort study of 4,535 National Health Insurance beneficiaries in Shiga].

AU - Okamura, Tomonori

AU - Nakamura, Koshi

AU - Hayakawa, Takehito

AU - Kanda, Hideyuki

AU - Miura, Katsuyuki

AU - Okayama, Akira

AU - Ueshima, Hirotsugu

PY - 2012/1

Y1 - 2012/1

N2 - A 10-year follow-up cohort study of 4,535 National Health Insurance beneficiaries aged 40 to 69 years in Shiga was performed as part of a research project conducted by the Health Promotion Research Committee of the Shiga National Health Insurance Organizations in 2002. The relationship between cardiovascular risk factors and medical expenditures during the 10-year study period has been examined in this cohort. For example, there was a positively graded correlation between blood pressure and individual total medical expenditures per month. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensives were also higher than those in normotensives. However, from the viewpoint of the entire population, the excess medical expenditures attributable to hypertension within the total medical expenditures were higher for mild-to-moderate hypertensives than for severe hypertensives. On the other hand, although individual medical expenditures per month were 1.7-fold higher for participants with 2 or 3 risk factors and obesity, which was broadly equivalent to metabolic syndrome, than for those without these factors, the excess medical expenditures determined by risk clustering within the total medical expenditures were higher in normal-weight people than in obese people because of the higher prevalence of normal weight. These findings suggest that high-risk individuals are a good target of a high-risk approach, such as intensive health guidance, from the viewpoint of medical expenditures. However, another approach for the majority with a low-to-moderate cardiovascular risk should be considered, because they account for a greater proportion of the excess medical expenditures. Another way to solve this problem may be a population approach with an effective method of providing information to citizens.

AB - A 10-year follow-up cohort study of 4,535 National Health Insurance beneficiaries aged 40 to 69 years in Shiga was performed as part of a research project conducted by the Health Promotion Research Committee of the Shiga National Health Insurance Organizations in 2002. The relationship between cardiovascular risk factors and medical expenditures during the 10-year study period has been examined in this cohort. For example, there was a positively graded correlation between blood pressure and individual total medical expenditures per month. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensives were also higher than those in normotensives. However, from the viewpoint of the entire population, the excess medical expenditures attributable to hypertension within the total medical expenditures were higher for mild-to-moderate hypertensives than for severe hypertensives. On the other hand, although individual medical expenditures per month were 1.7-fold higher for participants with 2 or 3 risk factors and obesity, which was broadly equivalent to metabolic syndrome, than for those without these factors, the excess medical expenditures determined by risk clustering within the total medical expenditures were higher in normal-weight people than in obese people because of the higher prevalence of normal weight. These findings suggest that high-risk individuals are a good target of a high-risk approach, such as intensive health guidance, from the viewpoint of medical expenditures. However, another approach for the majority with a low-to-moderate cardiovascular risk should be considered, because they account for a greater proportion of the excess medical expenditures. Another way to solve this problem may be a population approach with an effective method of providing information to citizens.

UR - http://www.scopus.com/inward/record.url?scp=84861168525&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84861168525&partnerID=8YFLogxK

U2 - 10.1265/jjh.67.38

DO - 10.1265/jjh.67.38

M3 - Article

VL - 67

SP - 38

EP - 43

JO - Nihon eiseigaku zasshi. Japanese journal of hygiene

JF - Nihon eiseigaku zasshi. Japanese journal of hygiene

SN - 0021-5082

IS - 1

ER -