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Associations Between Healthcare Resources and Healthy Life Expectancy: A Descriptive Study across Secondary Medical Areas in Japan.

ABSTRACT: Japan has the highest life expectancy in the world. However, this does not guarantee an improved quality of life. There is a gap between life expectancy and healthy life expectancy. This study aimed to reveal the features of healthy life expectancy across all secondary medical areas (n = 344) in Japan and examine the relationship among healthcare resources, life expectancy, and healthy life expectancy at birth. Data were collected from Japan's population registry and long-term insurance records. Differences in healthy life expectancy by gender were calculated using the Sullivan method. Maps of healthy life expectancy were drawn up. Descriptive statistics and correlation analysis were used for analysis. The findings revealed significant regional disparities. The number of doctors and therapists, support clinics for home healthcare facilities and home-visit treatments, and dentistry expenditure per capita were positively correlated with life expectancy and healthy life expectancy (correlation coefficients > 0.2). They also revealed gender differences. Despite controlling for population density, inequalities in healthy life expectancy were observed, highlighting the need to promote social policies to reduce regional disparities. Japanese policymakers should consider optimal levels of health resources to improve life expectancy and healthy life expectancy. The geographical distribution of healthcare resources should also be reconstituted.

SUBMITTER: Hosokawa R

PROVIDER: S-EPMC7503367 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Associations Between Healthcare Resources and Healthy Life Expectancy: A Descriptive Study across Secondary Medical Areas in Japan.

Hosokawa Rikuya R Ojima Toshiyuki T Myojin Tomoya T Aida Jun J Kondo Katsunori K Kondo Naoki N

International journal of environmental research and public health 20200829 17

Japan has the highest life expectancy in the world. However, this does not guarantee an improved quality of life. There is a gap between life expectancy and healthy life expectancy. This study aimed to reveal the features of healthy life expectancy across all secondary medical areas (<i>n</i> = 344) in Japan and examine the relationship among healthcare resources, life expectancy, and healthy life expectancy at birth. Data were collected from Japan's population registry and long-term insurance r ...[more]

PMID: 32872538

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Project description:BACKGROUND:Group-based trajectory modeling is a useful tool for categorizing students' academic trajectories and their determinants. Using insights gained from the analyses, we can identify students at risk for poor academic performance and monitor them to provide support. To date, studies investigating the associations between demographic factors and academic performance trajectories among medical students are scarce. The study objective was to examine the associations between demographic factors and academic performance trajectories in medical students using group-based trajectory modeling. METHODS:Participants included all medical students admitted to Tokyo Medical and Dental University in Japan in 2013 and 2014 (n = 202). Academic performance was evaluated by biannual grade point average (GPA) scores in preclinical years. We used group-based trajectory modeling to categorize students into GPA trajectories. Multinomial logistic regression was used to examine the association between the odds of being in a certain GPA trajectory group and demographic factors such as high school type, high school geographical area, admission test type, high school graduation year, whether the student was a biology major, and sex. RESULTS:Students' GPA trajectories were classified into four trajectory groups as well as another group that consisted of students who withdrew or repeated years. We found that students whose high school geographical area was outside the National Capital Region were 7.2 times more likely to withdraw or repeat years in comparison with students whose school was inside the National Capital Region (OR: 7.21, 95% CI: 1.87, 27.76). In addition, admission test type, high school graduation year, and sex were associated with GPA trajectories. CONCLUSIONS:High school geographical area, admission test type, high school graduation year, and sex were associated with GPA trajectories. These findings provide important insights into identifying students at risk for poor academic performance and strategies for monitoring them to provide adequate and timely support.

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Project description:BACKGROUND:The occurrence of multimorbidity (i.e., the coexistence of multiple chronic diseases) increases with age in older adults and is a growing concern worldwide. Multimorbidity has been reported to be a driving factor in the increase of medical expenditures in OECD countries. However, to the best of our knowledge, there is no published research that has examined the associations between multimorbidity and either long-term care (LTC) expenditure or the sum of medical and LTC expenditures worldwide. We, therefore, aimed to examine the associations of multimorbidity with the sum of medical and LTC expenditures for older adults in Japan. METHODS:Medical insurance claims data for adults ≥75 years were merged with LTC insurance claims data from Kashiwa city, a suburb in the Tokyo metropolitan area, for the period between April 2012 and September 2013 to obtain an estimate of medical and LTC expenditures. We also calculated the 2011 updated and reweighted version of the Charlson Comorbidity Index (CCI) scores. Then, we performed multiple generalized linear regressions to examine the associations of CCI scores (0, 1, 2, 3, 4, or ≥ 5) with the sum of annual medical and LTC expenditures, adjusting for age, sex, and household income level. RESULTS:The mean sum of annual medical and LTC expenditures was ¥1,086,000 (US$12,340; n = 30,042). Medical and LTC expenditures accounted for 66 and 34% of the sum, respectively. Every increase in one unit of the CCI scores was associated with a ¥257,000 (US$2920); 95% Confidence Interval: ¥242,000, 271,000 (US$2750, 3080) increase in the sum of the expenditures (p < 0.001; n = 29,915). CONCLUSIONS:Using a merged medical and LTC claims dataset, we found that greater CCI scores were associated with a higher sum of annual medical and LTC expenditures for older adults. To the best of our knowledge, this is the first study to examine the associations of multimorbidity with LTC expenditures or the sum of medical and LTC expenditures worldwide. Our study indicated that the economic burden on society caused by multimorbidity could be better evaluated by the sum of medical and LTC expenditures, rather than medical expenditures alone.

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Associations Between Healthcare Resources and Healthy Life Expectancy: A Descriptive Study across Secondary Medical Areas in Japan.

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Associations Between Healthcare Resources and Healthy Life Expectancy: A Descriptive Study across Secondary Medical Areas in Japan.

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