Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan.
J Epidemiol Community Health. 2022 Apr;76(4):391-397. doi: 10.1136/jech-2020-216158. Epub 2021 Oct 28.
Recognising the importance of the social determinants of health, the Japanese government introduced a health management support programme targeted at type 2 diabetes (T2D) for public assistance recipients (PAR) in 2018. However, evidence of the T2D prevalence among PAR is lacking. We aimed to estimate T2D prevalence by age and sex among PAR, compared with the prevalence among health insurance enrollees (HIE). Additionally, regional differences in T2D prevalence among PAR were examined.
This was a cross-sectional study using 1-month health insurance claims of both PAR and HIE. The Fact-finding Survey data on Medical Assistance and the National Database of Health Insurance Claims data were used. T2D prevalence among PAR and HIE were assessed by age and sex, respectively. Moreover, to examine regional differences in T2D prevalence of inpatients and outpatients among PAR, T2D crude prevalence and age-standardised prevalence were calculated by prefecture. Multilevel logistic regression analysis was also conducted at the city level.
T2D crude prevalence was 7.7% in PAR (inpatients and outpatients). Among outpatients, the prevalence was 7.5% in PAR and 4.1% in HIE, respectively. The mean crude prevalence and age-standardised prevalence of T2D (inpatients and outpatients) among 47 prefectures were 7.8% and 3.9%, respectively. In the city-level analysis, the OR for the prevalence of T2D by region ranged from 0.31 to 1.51.
The prevalence of T2D among PAR was higher than HIE and there were regional differences in the prevalence of PAR. Measures to prevent the progression of diabetes among PAR by region are needed.
认识到健康的社会决定因素的重要性，日本政府于 2018 年为公共援助受助人（PAR）推出了一项针对 2 型糖尿病（T2D）的健康管理支持计划。然而，缺乏 PAR 中 T2D 患病率的证据。我们旨在估计 PAR 中 T2D 的年龄和性别患病率，并与健康保险参保人（HIE）的患病率进行比较。此外，还检查了 PAR 中 T2D 患病率的地区差异。
这是一项使用 PAR 和 HIE 为期一个月的健康保险索赔的横断面研究。使用了《医疗援助事实调查数据》和《国家健康保险索赔数据库》的数据。PAR 和 HIE 中 T2D 的患病率分别按年龄和性别进行评估。此外，为了检查 PAR 中住院和门诊患者 T2D 患病率的地区差异，按县计算了 T2D 的粗患病率和年龄标准化患病率。还在市级水平进行了多水平逻辑回归分析。
PAR 中的 T2D 粗患病率为 7.7%（住院和门诊）。在门诊患者中，PAR 的患病率为 7.5%，HIE 的患病率为 4.1%。47 个县的 T2D（住院和门诊）的平均粗患病率和年龄标准化患病率分别为 7.8%和 3.9%。在市级分析中，T2D 患病率的地区比值比范围为 0.31 至 1.51。
PAR 中 T2D 的患病率高于 HIE，并且 PAR 的患病率存在地区差异。需要采取措施，根据地区情况，预防 PAR 中糖尿病的进展。
