title: Personal status of general health checkups and medical expenditure: A large-scale community-based retrospective cohort study.
abstract: BACKGROUND
  We sought to clarify the association between the personal utilization of general health checkups (GHCs) and medical expenditures (MEs) in a middle-aged Japanese population.
  
  
  METHODS
  A retrospective cohort study was conducted. Subjects were 33,417 residents (15,819 males and 17,598 females) aged 48 years or older in 2010 who were invited to undergo GHCs every year. Official records on GHCs from 2002 to 2007 and MEs from 2008 to 2010 were provided by Soka City, Saitama Prefecture, Japan. The utilization of GHCs was divided into zero times (non-utilizers), 1-3 times (low-frequency utilizers), and 4-6 times (high-frequency utilizers). Tweedie distributions in the generalized linear model were used to analyze the association between MEs and the subgroups of GHC utilization after adjustment for age and sex.
  
  
  RESULTS
  Of the 33,417 subjects, 20,578 (61.6%) were non-utilizers, 5,777 (17.3%) were low-frequency utilizers, and 7,062 (21.1%) were high-frequency utilizers, based on the attendance to GHCs from 2002 to 2007. Compared with the non-utilizers, the high-frequency utilizers showed significantly higher outpatient MEs (JPY394,700 vs. JPY373,100). The low- and high-frequency utilizers showed significantly lower inpatient MEs (JPY224,000 and JPY181,500 vs. JPY309,300) and total MEs (JPY610,600 and JPY580,700 vs. JPY689,600) than the non-utilizers based on the pooled data from 2008 to 2010.
  
  
  CONCLUSIONS
  This study suggests that the outpatient MEs rise when annual GHCs are increasingly attended (not including the GHC cost), but inpatient and total MEs are lower. To reduce MEs, increasing the rates of attendance at GHCs by the general public may be important.
authors.affiliation: Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan. Electronic address: yasuo-h@dokkyomed.ac.jp.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Haruyama
authors.affiliation: Soka City Health Center, Soka, Saitama, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Yamazaki
authors.affiliation: Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Motoki
authors.initials: M
authors.lastname: Endo
authors.affiliation: Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Kato
authors.affiliation: Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Nagao
authors.affiliation: Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Umesawa
authors.affiliation: Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Toshimi
authors.initials: T
authors.lastname: Sairenchi
authors.affiliation: Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Kobashi
mesh_terms: D000368:Aged; D015331:Cohort Studies; D055812:Community-Based Participatory Research; D005260:Female; D015438:Health Behavior; D017048:Health Care Costs; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007348:Insurance, Health; D007564:Japan; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data; D010808:Physical Examination / Q000191:economics / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000191:economics / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies
keywords: General health checkups; Health behavior; Medical consultation; Medical expenditures; Retrospective cohort study