National Institute of Public Health, Department of Health and Welfare Service Research, Wako, Saitama, Japan.
J Epidemiol. 2013;23(4):262-9. doi: 10.2188/jea.je20120136. Epub 2013 Jun 1.
Evidence is lacking on whether health guidance for metabolic syndrome reduces health care expenditures. The author used propensity-score matching to evaluate the effects of health guidance on health care expenditure.
Men who did and did not receive health guidance from a health insurance society (approximately 60 000 covered lives) were matched (n = 397 respectively) using propensity scores. Health insurance claims were compared using cumulative health care expenditures for metabolic syndrome-related outpatient medical care and drug costs for the period from the initial consultation to 3 years later.
No difference was observed between intervention and control groups in cumulative outpatient charges or drug costs related to metabolic syndrome. However, regression analysis using the Tobit model showed that health guidance resulted in a small, nonsignificant reduction in health care expenditure.
Health guidance for metabolic syndrome did not reduce outpatient charges or drug costs related to metabolic syndrome during the 3-year period after the intervention. Findings from Tobit regression suggest that health guidance might eventually result in savings, but this hypothesis remains untested.
缺乏代谢综合征健康指导是否能降低医疗保健支出的证据。作者使用倾向评分匹配来评估健康指导对医疗支出的影响。
使用倾向评分对参加和未参加医疗保险协会健康指导的男性（约 60000 名被保险人）进行匹配（分别为 397 人）。通过从初始咨询到 3 年后的代谢综合征相关门诊医疗保健支出和药物费用的累计医疗保健支出比较健康保险索赔。
干预组和对照组之间在代谢综合征相关的门诊费用或药物费用方面没有差异。然而，使用 Tobit 模型的回归分析表明，健康指导导致医疗保健支出略有、无统计学意义的减少。
在干预后的 3 年内，代谢综合征的健康指导并未降低与代谢综合征相关的门诊费用或药物费用。Tobit 回归的结果表明，健康指导最终可能会节省费用，但这一假设仍有待检验。
