Joint impact of health risks on health care charges: 7-year follow-up of National Health Insurance beneficiaries in Japan (the Ohsaki Study).
BACKGROUND
The objective of this study was to examine the joint impact of modifiable health-risk factors such as smoking, obesity, and physical inactivity on direct health care charges.


METHODS
We conducted a population-based prospective cohort study, with follow-up from 1995 to 2001. The participants were Japanese National Health Insurance (NHI) beneficiaries (26,110 men and women aged 40-79 years).


RESULTS
'No risk' group defined as never-smoking, body mass index (BMI) 20.0-24.9 kg/m(2), and walking for >/=1 h/day had mean health care charges of 171.6 dollars after adjustment for potential confounders. Compared with this group, the presence of smoking (SM; ever-smoking) alone, obesity alone (OB; BMI >/=25.0 kg/m(2)), or physical inactivity (PI; walking for <1 h/day) alone were associated with a 8.3%, 7.1%, or 8.0% increase in health care charges, respectively. The combinations of the risks of SM and OB, SM and PI, OB and PI, and SM and OB and PI were associated with a 11.7%, 31.4%, 16.4%, and 42.6% increase in charges, respectively.


CONCLUSIONS
Interventions to improve modifiable health-risk factors may be a cost-effective approach for reducing health care charges as well as improving people's health.
Kuriyama
Shinichi
S
Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan. kuriyama-thk@umin.ac.jp
Hozawa
Atsushi
A
Ohmori
Kaori
K
Suzuki
Yoshinori
Y
Nishino
Yoshikazu
Y
Fujita
Kazuki
K
Tsubono
Yoshitaka
Y
Tsuji
Ichiro
I
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000191:economics*; D015444:Exercise / Q000502:physiology; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health; D007564:Japan; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data; D009765:Obesity / Q000191:economics; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000191:economics