How was cognitive behavioural therapy for mood disorder implemented in Japan? A retrospective observational study using the nationwide claims database from FY2010 to FY2015
How was cognitive behavioural therapy for mood disorder implemented in Japan? A retrospective observational study using the nationwide claims database from FY2010 to FY2015
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DOI：
10.1136/bmjopen-2019-033365
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发表时间：
2020-05-01
期刊：
影响因子：
2.9
通讯作者：
Ishida, Yasushi
中科院分区：
文献类型：
--
作者：
Hayashi, Yuta;Yoshinaga, Naoki;Ishida, Yasushi
目的了解认知行为疗法（CBT）在日本国民健康保险制度下的传播状况。设计回顾性观察研究。设置日本国民健康保险索赔和特定健康检查数据库。参与者从财政年度（FY）开始在国民健康保险制度下接受CBT的患者。我们估计了接受CBT的患者数量的变化率和标准化索赔比率（SCR），并分析了CBT状态与几个区域因素之间的关联。结果我们发现：（a）在研究期间，共有60304名患者接受了CBT;（B）接受CBT的患者人数在第一年最多（2010财政年度至2015财政年度为-1.8%）;（c）每10万人接受CBT的病人数目减少在大多数县，（47人中有32人）;（d）各都道府县之间的CBT标准化申索比率最多相差424.7倍，以及（e）注册的CBT机构数量与接受CBT的患者数量显著相关。结论CBT的提供在前6年没有增加2010 -2015财政年度），其在日本国家健康保险计划中的覆盖范围。进一步的研究，包括注册的CBT机构的问卷调查，需要获得更详细的信息，在日本的传播CBT。
Objectives To clarify the dissemination status of cognitive behavioural therapy (CBT) in Japan under the national health insurance scheme.Design Retrospective observational study.Setting National Database of Health Insurance Claims and Specific Health Checkups of Japan.Participants Patients who received CBT under the national health insurance scheme from fiscal years (FY) 2010 to 2015.Primary and secondary outcome measures We estimated the change rate and the standardised claim ratio (SCR) for the number of patients receiving CBT and analysed the association between the CBT status and several regional factors.Results We found that (a) a total of 60 304 patients received CBT during the study period; (b) the number of patients receiving CBT was highest in the first year (-1.8% from FY2010 to FY2015); (c) the number of patients who received CBT per 100 000 population decreased (or remained at zero) in most prefectures (32 out of 47); (d) there was a maximum 424.7-fold difference between prefectures in the standardised claim ratio for CBT and (e) the number of registered CBT institutions was significantly associated with the number of patients who received CBT.Conclusions The provision of CBT did not increase in the first 6 years (FY2010-2015) after its coverage in Japan's national health insurance scheme. Further studies including a questionnaire survey of registered CBT institutions are required to get more detailed information on the dissemination of CBT in Japan.