Relationship between health promotion volunteer experience and medical costs: <i>Hoken-hodouin</i> activities in Suzaka, Nagano
Relationship between health promotion volunteer experience and medical costs: <i>Hoken-hodouin</i> activities in Suzaka, Nagano
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健康促进志愿者的经验与医疗费用的关系：长野县须坂市的<i>法轩法堂院</i>活动
DOI：
10.11236/jph.64.1_25
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
今村晴彦，村上義孝，岡村智教，西脇祐司
中科院分区：
文献类型：
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作者：
Mitsuo Hinoue;Sumiyo Ishimatsu;Yukiko Fueta;Hajime Hori;今村晴彦，村上義孝，岡村智教，西脇祐司
目的本研究表明，在日本的健康促进志愿者（Hoken-hodouin）的经验和医疗费用之间的关系。研究区域为Suzaka市（2016年3月人口：51，637），自1958年以来，共有约300名女性被聘为健康促进志愿者并接受培训。方法2014年采用自填问卷进行横断面调查，内容包括担任健康促进志愿者的经历，参与年龄，领导地位和对体验的满意度。合格的研究参与者是所有65岁或以上的Suzaka居民。收集了2013年4月至2014年3月日本国民健康保险受益人中65-74岁女性的医疗费用数据（n= 2，304）。门诊和住院诊所的医疗咨询率和治疗费用作为结果进行分析。对年龄、婚姻状况、教育水平、同居状况、同等收入、饮酒、吸烟状况、对健康饮食的认识以及每天步行时间进行了调整。结果在2，304名研究参与者中，1，274人（55.3%）有健康促进志愿者的经验。Poisson回归分析显示，志愿者的经历与门诊治疗率呈正相关（校正相对风险[RR]=1.04; 95%置信区间[CI]=1.02-1.07），与住院治疗率呈负相关（RR=0.74; 95% CI=0.56-0.98）。多变量回归分析显示，有志愿者经验的参与者的门诊和住院护理费用的调整几何平均值分别比没有志愿者经验的参与者低7%和23%（门诊费用为140，588 - 151，465日元;住院费用为418，457 - 539，971日元）。这些协会之间的参与者谁开始健康促进志愿者在60岁或以上，那些谁有领导作用，和参与者谁有高水平的满意度关于他们的志愿者experience.Conclusion这些结果表明，作为一个健康促进志愿者的经验与较低的医疗费用，特别是住院护理。
Objectives This study demonstrated the relationship between experience as a health promotion volunteer (Hoken-hodouin) and medical costs in Japan. The study area was Suzaka City (March 2016 population: 51,637) in Nagano Prefecture, Japan, where a total of about 300 women have been engaged and trained as health promotion volunteers since 1958.Methods A cross-sectional survey was conducted in 2014 using a self-administered questionnaire, which included items on experiences as a health promotion volunteer, age at engagement, leadership status, and satisfaction with the experience. Eligible study participants were all residents of Suzaka aged 65 years or over. Medical cost data from April 2013 to March 2014 were collected for women aged 65-74 years who were beneficiaries of the Japanese National Health Insurance (n=2,304). Medical consultation rates and costs for treatment at outpatient and inpatient clinics were analyzed as outcomes. Adjustments were made for age, marital status, educational level, cohabitation status, equivalent income, alcohol use, smoking status, awareness about a healthy diet, and walking time per day.Results Of the 2,304 study participants, 1,274 (55.3%) had experience as health promotion volunteers. Poisson regression analysis revealed that volunteers' experience was positively associated with outpatient care rates (adjusted relative risk [RR]=1.04; 95% confidence interval [CI]=1.02-1.07), and negatively associated with inpatient care rates (RR=0.74; 95% CI=0.56-0.98). Multivariate regression analysis revealed that the adjusted geometric means of outpatient and inpatient care costs were 7% and 23% lower, respectively, among participants with volunteer experience than that among those with no volunteer experience (140,588-151,465 JPY for outpatient costs; 418,457-539,971 JPY for inpatient costs). These associations were stronger among participants who began health promotion volunteer at age 60 years or more, those who had leadership roles, and participants who had high levels of satisfaction regarding their volunteer experience.Conclusion These results suggest that experience as a health promotion volunteer is associated with lower medical costs, particularly for inpatient care.