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日本国家健康筛查与干预项目旨在预防代谢综合征的恶化。

The Japanese national health screening and intervention program aimed at preventing worsening of the metabolic syndrome.

作者信息

Kohro Takahide, Furui Yuji, Mitsutake Naohiro, Fujii Ryo, Morita Hiroyuki, Oku Shinya, Ohe Kazuhiko, Nagai Ryozo

机构信息

Department of Translational Research for Healthcare and Clinical Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

Int Heart J. 2008 Mar;49(2):193-203. doi: 10.1536/ihj.49.193.

Abstract

Similar to the healthcare systems in other industrialized countries, the Japanese healthcare system is facing the problem of increasing medical expenditure. In Japan, this situation may be primarily attributed to advanced technological developments, an aging population, and increasing patient demand. Japan also faces the problem of a declining youth population due to a low birth rate. Taken together, these problems present the healthcare system with a very difficult financial situation. Several reforms have been undertaken to contain medical expenditure, such as increasing employee copayment for health insurance from 10% to 20% in 1997 and from 20% to 30% in 2003 in order to curb unnecessary visits to medical institutions. Since the aging of the Japanese population is inevitable, a suitable method to contain medical expenditure may be to screen individuals who are likely to develop lifestyle-related diseases and conduct early intervention programs for them to prevent the development of diseases such as myocardial infarction or stroke that are costly to treat. If this goal is attained, it may contribute to the containment of medical expenditure as well as to improving the quality of life of the elderly. Therefore, the Japanese Ministry of Health, Labor and Welfare has decided to introduce a nationwide health screening and intervention program specifically targeting the metabolic syndrome commencing April 2008. Here, we discuss (1) the background of the Japanese healthcare system and the problems facing it, (2) the underlying objective and details of the new screening program, and (3) the expected impact of the program.

摘要

与其他工业化国家的医疗体系类似,日本的医疗体系正面临医疗支出不断增加的问题。在日本,这种情况主要可能归因于技术的先进发展、人口老龄化以及患者需求的增加。由于出生率低,日本还面临青年人口减少的问题。综合起来,这些问题给医疗体系带来了非常困难的财政状况。已经进行了几项改革以控制医疗支出,比如1997年将健康保险的员工自付费用从10%提高到20%,2003年又从20%提高到30%,以遏制对医疗机构不必要的就诊。鉴于日本人口老龄化不可避免,一种合适的控制医疗支出的方法可能是筛查有可能患生活方式相关疾病的个体,并为他们开展早期干预项目,以预防诸如心肌梗死或中风等治疗费用高昂的疾病的发生。如果实现这一目标,可能有助于控制医疗支出以及提高老年人的生活质量。因此,日本厚生劳动省已决定自2008年4月起推出一项专门针对代谢综合征的全国性健康筛查和干预项目。在此,我们讨论:(1)日本医疗体系的背景及其面临的问题;(2)新筛查项目的基本目标和细节;(3)该项目的预期影响。

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