Relation Between Use of Healthy CheckーUps by Adults Starting in Middle Age and Demand for InーPatient Care by the Elderly

目标-日本的《老年人保健服务法》规定进行一般健康检查。研究目的：调查40岁以上的老年人使用这些检查的情况与70岁以上的老年人对住院治疗的需求之间的相关性。调查设计和背景：1988年，向日本509个城市的30，000 ~ 199，999人的人口邮寄了调查问卷。测量方法--按城市规模和人均床位数的不同类别计算了一般健康检查的对数利用率与对数平均床日数之间的相关系数。为了比较相对变化而不是绝对变化，我们分析了改善指数之间的相关性（从1983年到1986年的变化率乘以目标实现率或全国平均值）。主要结果--在健康检查利用率较高的城市，平均住院日和平均住院费用都有较低的趋势。检查利用率的对数与对数平均床日数的相关系数按城市规模和一定的床位数类别均为负值。有倾向于更高的使用率在1983年的这些检查，相关性是显着的60%或以上的比率。结论--强有力的健康服务计划，开始在中年减少老年人的住院护理需求。在一年内，使用率从25.5%增加到27.6%，估计为850万老年人节省了226万个卧床日。

Objective--The Health Services for the Elderly Act in Japan provides for general health check-ups. We looked for a correlation between the use of these check-ups by adults (40 or older) and demand for in-patient care of the elderly (70 or older).Design and setting--For this survey, a questionnaires was mailed in 1988 to all 509 Japanese cities with a population of 30,000-199,999. They were all returned with data for 1983 and 1986.Measurements--We calculated correlation coefficients between the logarithmic rates of use of general health check-ups and logarithmic mean bed-days by size of cities and certain categories of number of beds per population. To compare relative changes rather than absolute ones, we analyzed correlation between improvement indices (ratio of change from 1983 to 1986 times the percentage of achievement of a goal or national mean.)Main results--In cities with relatively high rates of use of health check-ups, both the mean bed-days and the mean in-patient fee tended to be low. Correlation coefficients between the logarithmic rates of use of check-ups and logarithmic mean bed-days were all minus values by sizes of cities and certain categories of number of beds. There tended to be more correlation for higher rates of use in 1983 of these check-ups, and the correlation was significant for the rate of 60% or more.Conclusions--Strong health-service programs for starting in middle age decrease the demand for in-patient care of the elderly. In a single year, an increase in the rate of use from 25.5% to 27.6% was calculated to have saved 2.26 million bed-days for the total of 8.5 million of elderly persons.