title: C-reactive protein (CRP) is a predictor of high medical-care expenditures in a community-based elderly population aged 70 years and over: the Tsurugaya project.
abstract: Because CRP is a strong independent predictor of various diseases, it was hypothesized that CRP may be a useful predictor or treatment target for medical-care expenditures. The aim of this study was to investigate the relationship between CRP and medical-care expenditures in a community-dwelling elderly population. This prospective cohort study was conducted including 925 Japanese subjects aged ≥70 years. A high-sensitivity CRP assay was used by applying the nephelometric method. Hospitalizations, outpatient visits, and expenditures were ascertained through computerized linkage with claims lodged between August 2002 and March 2008 with the Miyagi National Health Insurance (NHI) Association. Since medical-care expenditures were not normally distributed, the category of high medical-care expenditures (>75th percentile of medical-care expenditures: inpatient expenditures >$494/month; outpatient expenditure >$522/month; total expenditures >$1103/month) was used to examine the relation of CRP levels with medical-care expenditures. Multiple logistic regression analysis was used to examine the relationship between CRP cutoff points (low concentrations: <1.0mg/L; intermediate concentrations: 1.0-3.0mg/L; or high concentrations: ≥3.0 mg/L) and medical-care expenditures during 6 year-follow up period. After adjustment for potential confounding factors, a positive association of CRP with hospitalization, and total expenditures (p for trend=0.03 and 0.02, respectively) was found. An elevated baseline CRP level is an independent predictor of increases in prospective medical-care expenditures among community-dwelling elderly. Further study is required to clarify whether reducing CRP by intervention is a cost-effective measure.
authors.affiliation: Division of Biomedical Engineering for Health & Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan. nkj0809@gmail.com
authors.forename: Kaijun
authors.initials: K
authors.lastname: Niu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hozawa
authors.forename: Hui
authors.initials: H
authors.lastname: Guo
authors.forename: Kaori
authors.initials: K
authors.lastname: Ohmori-Matsuda
authors.forename: Yufei
authors.initials: Y
authors.lastname: Cui
authors.forename: Satoru
authors.initials: S
authors.lastname: Ebihara
authors.forename: Naoki
authors.initials: N
authors.lastname: Nakaya
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kuriyama
authors.forename: Toru
authors.initials: T
authors.lastname: Tsuboya
authors.forename: Masako
authors.initials: M
authors.lastname: Kakizaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohrui
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Arai
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tsuji
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Nagatomi
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D016015:Logistic Models; D008297:Male; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data; D011446:Prospective Studies; D012111:Residence Characteristics
chemical_list: D002097:C-Reactive Protein