Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
J Hypertens. 2012 Sep;30(9):1874-9. doi: 10.1097/HJH.0b013e3283568781.
The nation-wide, community-based intensive hypertension detection and control program, as well as universal health insurance coverage, may well be contributing factors for helping Japan rank near the top among countries with the longest life expectancy. We sought to examine the cost-effectiveness of such a community-based intervention program, as no evidence has been available for this issue.
The hypertension detection and control program was initiated in 1963 in full intervention and minimal intervention communities in Akita, Japan. We performed comparative cost-effectiveness and budget-impact analyses for the period 1964-1987 of the costs of public health services and treatment of patients with hypertension and stroke on the one hand, and incidence of stroke on the other in the full intervention and minimal intervention communities.
The program provided in the full intervention community was found to be cost saving 13 years after the beginning of program in addition to the fact of effectiveness that; the prevalence and incidence of stroke were consistently lower in the full intervention community than in the minimal intervention community throughout the same period. The incremental cost was minus 28,358 yen per capita over 24 years.
The community-based intensive hypertension detection and control program was found to be both effective and cost saving. The national government's policy to support this program may have contributed in part to the substantial decline in stroke incidence and mortality, which was largely responsible for the increase in Japanese life expectancy.
全国性的、以社区为基础的强化高血压检测和控制计划，以及全民健康保险覆盖，可能是帮助日本在预期寿命最长的国家中排名接近前列的因素之一。我们试图研究这种以社区为基础的干预计划的成本效益，因为对此问题尚无证据。
高血压检测和控制计划于 1963 年在日本秋田县的全面干预和最小干预社区开始实施。我们对 1964 年至 1987 年期间公共卫生服务成本和高血压及中风患者治疗成本进行了比较成本效益和预算影响分析，另一方面则对全面干预和最小干预社区中风发病率进行了分析。
该计划在实施 13 年后，除了有效之外，还被发现具有成本效益；在同一时期，全面干预社区中风的患病率和发病率始终低于最小干预社区。24 年内人均增量成本为负 28358 日元。
以社区为基础的强化高血压检测和控制计划既有效又具有成本效益。国家政府支持该计划的政策可能在一定程度上促成了中风发病率和死亡率的大幅下降，这在很大程度上导致了日本预期寿命的延长。
