Nakamura Koshi, Kudaka Shota, Sakima Atsushi
Department of Public Health and Epidemiology, Graduate School of Medicine, University of the Ryukyus, Ginowan, Okinawa, Japan.
Health Administration Center, University of the Ryukyus, Nishihara, Okinawa, Japan.
Hypertens Res. 2025 Aug 5. doi: 10.1038/s41440-025-02316-7.
This longitudinal study investigated whether a worksite healthcare policy of making time for medical visits (exposure factor) facilitated attendance (outcome) at these visits for treatment of newly identified hypertension after a health checkup. The study included employees at small-to-medium companies in Okinawa, Japan, who had a systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, no history of hypertension in the last year, and were not taking antihypertensive medication. Pre-existing data on worksite characteristics, employees' health checkups, and health insurance claims were collected. A multilevel logistic regression model was used to calculate the odds ratio for the worksite group providing time to attend the medical visit, with the worksite group not providing this time acting as the reference. In the 2906 participants with newly identified hypertension employed at 1366 worksites, the cumulative incidence of interest increased gradually with longer follow-up in both groups, although the incidence was higher in the group providing time for the visit. After adjustment for potential confounding factors, the odds ratios (95% confidence interval) for visits by the end of the 4th, 5th, and 6th months after the health checkup in the group with time for a medical visit were 1.80 (1.13-2.86), 1.72 (1.10-2.70), and 1.55 (0.99-2.45), respectively. Similar patterns were observed for every stratum of company size, business category, and healthcare administrator status. These results indicate that a worksite making time for a visit to a medical facility was associated with increased visits by employees with newly identified hypertension at a health checkup.
这项纵向研究调查了一项工作场所医疗保健政策，即留出时间进行医疗就诊（暴露因素）是否有助于在健康检查后对新确诊的高血压进行治疗时的就诊率（结果）。该研究纳入了日本冲绳县中小型公司的员工，这些员工收缩压≥140mmHg或舒张压≥90mmHg，过去一年无高血压病史，且未服用抗高血压药物。收集了关于工作场所特征、员工健康检查和健康保险理赔的现有数据。采用多水平逻辑回归模型计算为员工提供就诊时间的工作场所组的优势比，以未提供此时间的工作场所组作为对照。在1366个工作场所工作的2906名新确诊高血压的参与者中，两组的累积发病率随随访时间延长逐渐增加，尽管提供就诊时间组的发病率更高。在对潜在混杂因素进行调整后，有时间就诊组在健康检查后第4、5和6个月末就诊的优势比（95%置信区间）分别为1.80（1.13 - 2.86）、1.72（1.10 - 2.70）和1.55（0.99 - 2.45）。在公司规模、业务类别和医疗保健管理人员身份的每个分层中都观察到了类似的模式。这些结果表明，为员工留出时间前往医疗机构就诊与健康检查中新确诊高血压的员工就诊率增加有关。
