ArticleBMJ open2022
Impact of the national health guidance intervention for obesity and cardiovascular risks on healthcare utilisation and healthcare spending in working-age Japanese cohort: regression discontinuity design.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 3 citations in OpenAlex.
- Association between nonrestorative sleep and increased healthcare costs: a 6-year cohort study.Sleep and biological rhythms · 2026Article
- Changes in body weight, awareness, and behaviors among workers participating in an online specific health guidance program incorporating multiple nudges: a process evaluation.Environmental and occupational health practice · 2026Article
- Assessment of the Representation of Civil Servants as the General Population in Terms of Health Checkup Data.Cureus · 2025Article
- Effect of visceral fat on onset of metabolic syndrome.Scientific reports · 2025Article
- Prevalent and new use of common drugs for the incidence of community-acquired acute kidney injury: cohort and case-crossover study.Scientific reports · 2024Article
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Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivesIncreases in obesity and cardiovascular diseases contribute to rapidly growing healthcare expenditures in many countries. However, little is known about whether the population-level health guidance intervention for obesity and cardiovascular risk factors is associated with reduced healthcare utilisation and spending. The aim of this study was to investigate the effect of population-level health guidance intervention introduced nationally in Japan on healthcare utilisation and spending.
designRetrospective cohort study, using a quasiexperimental regression discontinuity design.
settingJapan's nationwide employment-based health insurers.
participantsParticipants in the national health screening programme (from January 2014 to December 2014) aged 40-74 years. PREDICTORS: Assignment to health guidance intervention (counselling on healthy lifestyles, and referral to physicians as needed) determined primarily on whether the individual's waist circumference was above or below the cut-off value in addition to having at least one cardiovascular risk factor. PRIMARY AND SECONDARY OUTCOME MEASURES: Healthcare utilisation (the number of outpatient visits days, any medication use and any hospitalisation use) and spending (total medical expenditure, outpatient medical expenditure and inpatient medical expenditure) within 3 years of the intervention.
resultsA total of 51 213 individuals within the bandwidth (±6 cm of waist circumference from the cut-off) out of 113 302 screening participants (median age 50.0 years, 11.9% woman) were analysed. We found that the assignment to the national health guidance intervention was associated with fewer outpatient visit days (-1.3 days; 95% CI, -11.4 to -0.5 days; p=0.03). We found no evidence that the assignment to the health guidance intervention was associated with changes in medication or hospitalisation use, or healthcare spending.
conclusionAmong working-age, male-focused Japanese from a health insurer of companies of civil engineering and construction, the national health guidance intervention might be associated with a decline in outpatient visits, with no change in medication/hospitalisation use or healthcare spending.
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