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在日本,对预防保健服务的投资能否降低参加健康保险协会的人的医疗费用?

Could investment in preventive health care services reduce health care costs among those insured with health insurance societies in Japan?

机构信息

1 Department of Health Services Management and Policy, Graduate School of Medical Sciences, Kyushu University , Fukuoka, Japan .

出版信息

Popul Health Manag. 2014 Feb;17(1):42-7. doi: 10.1089/pop.2013.0007. Epub 2013 Oct 17.

Abstract

This study examined the impact of expenditures for preventive health care services on health care costs among those insured with health insurance societies in Japan using cross-sectional and longitudinal designs. The subjects of the study were those insured with Japan's 1481 health insurance societies belonging to the National Federation of Health Insurance Societies in 2003 and 2007. Multiple regression analyses were conducted using the forced entry method. Case rates, number of service days, and health care costs were used as dependent variables, and preventive health care expenditures, average age, number of the insured, gender ratio, average monthly salary, and dependents ratio were used as independent variables. Expenditures for preventive health care services showed significant negative correlations with both the number of service days and health care costs for inpatient and outpatient services in 2003 and 2007. The results showed that expenditures for preventive health care services had a negative relationship with health care costs. Thus, these findings support the effects of investment in preventive health activities as promoted by health insurance societies to reduce health care costs.

摘要

本研究采用横断和纵向设计,考察了日本健康保险协会参保者的预防保健服务支出对医疗费用的影响。研究对象为 2003 年和 2007 年参加日本全国健康保险联合会所属 1481 个健康保险协会的参保者。采用强制进入法进行多元回归分析。以就诊率、服务天数和医疗费用为因变量,以预防保健服务支出、平均年龄、参保人数、性别比、平均月薪和抚养比为自变量。2003 年和 2007 年,预防保健服务支出与住院和门诊服务的服务天数和医疗费用呈显著负相关。结果表明,预防保健服务支出与医疗费用呈负相关。因此,这些发现支持健康保险协会投资预防保健活动以降低医疗费用的效果。

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