title: Alcohol consumption, hospitalization and medical expenditure: a large epidemiological study on the medical insurance system in Japan.
abstract: OBJECTIVE
  This study investigated the relationship between alcohol drinking habits and the onset of high medical expenditure in a Japanese male population.
  
  
  METHODS
  The cohort comprised 94,307 male beneficiaries 40-69 years of age of the Japanese medical insurance system, who had daily alcohol drinking habits. The likelihood of incurring high medical expenditure, defined as the ≥90th percentile of the medical expenditure distribution in the study population 1 year after baseline, as well as the likelihood of undergoing hospitalization that year were compared among the participants grouped according to their alcohol consumption amount (<2, 2-3.9, 4-5.9, ≥6 drinks/day).
  
  
  RESULTS
  Participants who ranked in the top 10% medical expenditure group within the 1 year after baseline each incurred at least 2152 euros/year. The top 10% medical expenditure group accounted for 61.1% of the total medical expenditure in the study population. The odds ratios (95% confidence intervals) for ranking in the top 10% group during the 1-year period, compared with the <2 drinks (23 g of alcohol)/day group, were 1.08 (1.02-1.15) for 2-3.9 drinks/day, 1.11 (1.05-1.19) for 4-5.9 drinks/day, and 1.31 (1.18-1.45) for ≥6 drinks/day after adjustment for age, body mass index, and smoking and exercise habits. The adjusted odds ratios for undergoing hospitalization were 1.11 (1.04-1.19), 1.14 (1.06-1.24) and 1.39 (1.24-1.56), respectively.
  
  
  CONCLUSIONS
  The likelihood of incurring high medical expenditure and undergoing hospitalization increased with daily alcohol consumption amount.
authors.affiliation: Department of Epidemiology and Public Health, Kanazawa Medical University, Uchinada, Japan knaka@kanazawa-med.ac.jp.
authors.forename: Koshi
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan.
authors.forename: Nagako
authors.initials: N
authors.lastname: Okuda
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.affiliation: Department of Public Health, and Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.affiliation: Department of Evidence Based Medicine and Risk Analysis, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Nishimura
authors.affiliation: Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Yasumura
authors.affiliation: Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Yahaba, Japan.
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Sakata
authors.affiliation: Medical and Health Care Center, Sanyo Electric Group Health Insurance Association, Moriguchi, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Hidaka
authors.affiliation: Research Institute of Strategy for Prevention, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000191:economics / Q000453:epidemiology*; D000437:Alcoholism / Q000191:economics / Q000453:epidemiology*; D015331:Cohort Studies; D016021:Epidemiologic Studies; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged