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《老年保健服务法》规定了全面的健康检查。我们寻找成年人(40岁或以上)使用这些体检的情况与老年人(70岁或70岁以上)住院护理需求之间的相关性。设计和设置--为了进行这项调查，1988年向日本所有509个人口在30,000-199,999人的城市邮寄了一份问卷。我们计算了普通体检使用率与城市规模和某些人口床位类别的对数平均卧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，我们分析了改善指标之间的相关性(1983年至1986年的变化比率乘以目标或全国平均水平的完成百分比)。主要结果-在健康检查使用率相对较高的城市，平均卧床天数和平均住院费都趋于较低。体检使用率与对数平均卧床日数之间的相关系数按城市规模和某些床位类别均为负值。1983年这些体检的使用率越高，相关性越大，60%或以上的相关性显著。结论--从中年开始的强有力的卫生服务项目降低了老年人对住院护理的需求。在一年内，使用率从25.5%增加到27.6%，计算起来就为850万老年人节省了226万个床位日。

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.