Effectiveness of health guidance on the outcomes of specific health checkup in National Health Insurance subscribers

• Published in: Japanese Journal of Health and Human Ecology Vol. 85; no. 6; pp. 216 - 230
• Main Authors: KINOSHITA, Setsuko, KAYABA, Kazunori, NOBUHARA, Hiroaki
• Format: Journal Article
• Language: Japanese
• Published: Tokyo The Japanese Society of Health and Human Ecology 30.11.2019; Japan Science and Technology Agency
• Subjects: Body mass index; Body size; Dyslipidemia; Generalized linear models; Glucose tolerance; Health; Health guidance; Hypertension; Large population; Metabolic disorders; Metabolic syndrome; National health insurance; Obesity; Reduction; Regression analysis; Screening; Specific health checkup; Statistical analysis; Statistical models; Triglycerides; Women
• ISSN: 2432-6712; 2432-6720
• DOI: 10.3861/kenko.85.6_216

Objective: We aimed to evaluate the effectiveness of specific health guidance on the outcomes of health checkup in a three-year continuing screening program for a large population.Methods: Among the 422,389 examinees of the specific health checkup system, individuals undergoing a three-year continuing screening from 2008 to 2010 were divided into nine groups according to the existence or non-existence of health guidance practices. We compared the outcomes of the health checkups conducted in 2008 and those conducted in 2010 for 84,831 men and 132,449 women. More specifically, we analyzed the annual changes in the clinical measurements using the generalized linear model with the ages recorded in 2008 as covariates. Further, the annual changes in the prevalence of metabolic syndrome, obesity, dyslipidemia, hypertension, impaired glucose tolerance, and smoking were examined using the McNemar test.Results: The participants who received health guidance in 2008 and did not need guidance in 2009 revealed the greatest change rate in mean body mass index reduction, mean waist circumference re duction, mean triglyceride levels, and mean high-density lipoprotein levels compared with those who needed health guidance in 2008. The participants who received health guidance in both 2008 and 2009 revealed the greatest reduction in the prevalence of obesity for men and women ［men, −12.1 percent points (pp), p＜0.001; women, −14.9 pp, p＜0.001］.Discussion: Although the unrandomized controlled study, the statistical phenomenon of regression to the mean, and selection bias could be limitations, a positive effect of health guidance was observed on the outcomes of the health checkups for a large population.