Prevalence of type 2 diabetes by age, sex and geographical area among two million public assistance recipients in Japan: a cross-sectional study using a nationally representative claims database
Prevalence of type 2 diabetes by age, sex and geographical area among two million public assistance recipients in Japan: a cross-sectional study using a nationally representative claims database
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DOI：
10.1136/jech-2020-216158
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发表时间：
2021-10-25
影响因子：
6.3
通讯作者：
Takahashi, Yoshimitsu
中科院分区：
文献类型：
--
作者：
Sengoku, Tami;Ishizaki, Tatsuro;Takahashi, Yoshimitsu
日本政府认识到健康的社会决定因素的重要性，于2018年为公共援助接受者（PAR）推出了一项针对2型糖尿病（T2D）的健康管理支持计划。然而，缺乏PAR中T2D患病率的证据。我们的目的是根据年龄和性别估计PAR中T2D的患病率，并将其与健康保险参保者（HIE）的患病率进行比较。此外，还研究了PAR中T2D患病率的地区差异。方法采用1个月的PAR和HIE健康保险索赔进行横断面研究。使用了医疗援助实况调查数据和国家健康保险索赔数据库数据。PAR和HIE患者的T2D患病率分别按年龄和性别进行评估。此外，为了检验PAR住院和门诊患者T2D患病率的地区差异，按地区计算T2D粗患病率和年龄标准化患病率。在城市层面也进行了多水平logistic回归分析。结果PAR患者（住院和门诊）T2D粗患病率为7.7%。门诊患者中PAR患病率为7.5%，HIE患病率为4.1%。47个地市T2D（住院和门诊）平均粗患病率和年龄标准化患病率分别为7.8%和3.9%。在城市层面分析中，各地区T2D患病率的OR值为0.31 ~ 1.51。结论PAR人群中T2D患病率高于HIE，且PAR患病率存在地区差异，需采取措施预防PAR人群糖尿病进展。
Background Recognising the importance of the social determinants of health, the Japanese government introduced a health management support programme targeted at type 2 diabetes (T2D) for public assistance recipients (PAR) in 2018. However, evidence of the T2D prevalence among PAR is lacking. We aimed to estimate T2D prevalence by age and sex among PAR, compared with the prevalence among health insurance enrollees (HIE). Additionally, regional differences in T2D prevalence among PAR were examined. Methods This was a cross-sectional study using 1-month health insurance claims of both PAR and HIE. The Fact-finding Survey data on Medical Assistance and the National Database of Health Insurance Claims data were used. T2D prevalence among PAR and HIE were assessed by age and sex, respectively. Moreover, to examine regional differences in T2D prevalence of inpatients and outpatients among PAR, T2D crude prevalence and age-standardised prevalence were calculated by prefecture. Multilevel logistic regression analysis was also conducted at the city level. Results T2D crude prevalence was 7.7% in PAR (inpatients and outpatients). Among outpatients, the prevalence was 7.5% in PAR and 4.1% in HIE, respectively. The mean crude prevalence and age-standardised prevalence of T2D (inpatients and outpatients) among 47 prefectures were 7.8% and 3.9%, respectively. In the city-level analysis, the OR for the prevalence of T2D by region ranged from 0.31 to 1.51. Conclusion The prevalence of T2D among PAR was higher than HIE and there were regional differences in the prevalence of PAR. Measures to prevent the progression of diabetes among PAR by region are needed.