Nakamura Koshi, Okuda Nagako, Okamura Tomonori, Miura Katsuyuki, Nishimura Kunihiro, Yasumura Seiji, Sakata Kiyomi, Hidaka Hideki, Okayama Akira
Department of Epidemiology and Public Health, Kanazawa Medical University, Uchinada, Japan
Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan.
Alcohol Alcohol. 2015 Mar;50(2):236-43. doi: 10.1093/alcalc/agu089. Epub 2014 Dec 17.
This study investigated the relationship between alcohol drinking habits and the onset of high medical expenditure in a Japanese male population.
The cohort comprised 94,307 male beneficiaries 40-69 years of age of the Japanese medical insurance system, who had daily alcohol drinking habits. The likelihood of incurring high medical expenditure, defined as the ≥90th percentile of the medical expenditure distribution in the study population 1 year after baseline, as well as the likelihood of undergoing hospitalization that year were compared among the participants grouped according to their alcohol consumption amount (<2, 2-3.9, 4-5.9, ≥6 drinks/day).
Participants who ranked in the top 10% medical expenditure group within the 1 year after baseline each incurred at least 2152 euros/year. The top 10% medical expenditure group accounted for 61.1% of the total medical expenditure in the study population. The odds ratios (95% confidence intervals) for ranking in the top 10% group during the 1-year period, compared with the <2 drinks (23 g of alcohol)/day group, were 1.08 (1.02-1.15) for 2-3.9 drinks/day, 1.11 (1.05-1.19) for 4-5.9 drinks/day, and 1.31 (1.18-1.45) for ≥6 drinks/day after adjustment for age, body mass index, and smoking and exercise habits. The adjusted odds ratios for undergoing hospitalization were 1.11 (1.04-1.19), 1.14 (1.06-1.24) and 1.39 (1.24-1.56), respectively.
The likelihood of incurring high medical expenditure and undergoing hospitalization increased with daily alcohol consumption amount.
本研究调查了日本男性人群饮酒习惯与高额医疗费用发生之间的关系。
该队列包括94307名40至69岁有日常饮酒习惯的日本医疗保险系统男性受益人群。根据参与者的酒精摄入量（<2、2 - 3.9、4 - 5.9、≥6杯/天）分组，比较基线后1年研究人群中医疗费用分布处于≥第90百分位数定义的高额医疗费用发生可能性，以及当年住院的可能性。
基线后1年内医疗费用排名前10%的参与者每人每年至少花费2152欧元。医疗费用排名前10%的组占研究人群总医疗费用的61.1%。在调整年龄、体重指数、吸烟和运动习惯后，与每天饮用<2杯（23克酒精）的组相比，1年期间医疗费用排名前10%组的比值比（95%置信区间），对于每天饮用2 - 3.9杯为1.08（1.02 - 1.15），对于每天饮用4 - 5.9杯为1.11（1.05 - 1.19），对于每天饮用≥6杯为1.31（1.18 - 1.45）。住院的调整后比值比分别为1.11（1.04 - 1.19）、1.14（1.06 - 1.24）和1.39（1.24 - 1.56）。
高额医疗费用发生和住院的可能性随每日酒精摄入量增加而增加。
