Health benefits of reduced patient cost sharing in Japan
Akihiro Nishi, J Michael McWilliams, Haruko Noguchi, Hideki Hashimoto, Nanako Tamiya & Ichiro Kawachi
Volume 90, Number 6, June 2012, 426-435A
Table 1. Demographic characteristics, medical spending and health status of older adults, 2007 Comprehensive Survey of People’s Living Conditions, Japan
|Characteristic||Eligiblea for reduced cost sharing
at 70 years of age
|Not eligiblea for reduced cost sharing
at 70 years of age
n = 3 837c
n = 3 769c
n = 966c
n = 554c
|Marital status||< 0.001||0.005|
|Mean, no. of persons||2.72||2.73||2.72||2.59|
|Standard error, no. of persons||0.023||0.026||0.042||0.059|
|Occupational status||< 0.001||< 0.001|
|Not working, %||12.9||74.5||35.6||59.0|
|Metropolitan area, %||15.9||14.1||19.6||21.1|
|Large city (population: > 150 000), %||26.8||25.6||30.4||31.2|
|Medium city (population: 50 000–150 000), %||27.9||28.3||27.2||26.4|
|Small city (population: < 50 000), %||14.7||14.4||10.2||9.6|
|Town or village, %||14.6||17.5||12.5||11.7|
|Reported health-care usee||< 0.001||< 0.001|
|Out-of-pocket medical spendingf||< 0.001||0.259|
|Standard error, US$||1.41||1.15||2.66||3.48|
|Physical healthg||< 0.001||< 0.001|
a The cost-sharing rate decreased from 30% to 10% at the age of 70 years for individuals who had an annual taxable income under 12 000 United States dollars (US$).
b χ2 tests were used to compare distributions of categorical variables and t tests were used for continuous variables.
c Because values were missing for some variables, the sample sizes for each two-by-two table were smaller than these numbers. Moreover, the total number of individuals was 9126, which is smaller than the number of the study participants (n = 10 293) because data on income eligibility were missing.
d The size of the settlement where the individual lived at the time of the Comprehensive Survey of People’s Living Conditions.
e Health-care use reported at the time of the Comprehensive Survey of People’s Living Conditions.
f Spending in Japanese yen was converted into US$ using the rate that applied in July 2007 of approximately 120 Japanese yen per US$.
g Physical health status was evaluated on a scale of 0 to 16 points and was calculated from the sum of four questionnaire health measures: (i) general health status was assessed by asking, “How is your current health status?” (4 if excellent, 3 if very good, 2 if good, 1 if fair and 0 if poor); (ii) mobility was assessed by asking, “How many days have you been in bed (i.e. bed-ridden) because of health-related problems in the previous one month?” (4 if never, 3 if 1 to 3 days, 2 if 4 to 6 days, 1 if 7 to 14 days and 0 if 15 days or more); (iii) self-care and activities of daily living were assessed by asking, “Do you have difficulty with any of the following four areas in your daily life due to your physical health?: daily movements (e.g. getting up, wearing clothes, eating and bathing); staying outdoors; work, housework or studying; and, exercise or sport” (4 if no difficulties, 3 if difficulty in one area, 2 if difficulty in two areas, 1 if difficulty in three areas and 0 if difficulty in all four areas); (iv) pain was assessed by asking, “Do you have pain in the head, stomach, back or extremities?” (4 if no pain, 3 if pain in one location, 2 if pain in two locations, 1 if pain in three locations and 0 if pain in all four locations).
h Mental health status was evaluated on a scale of 0 to 24 points using a reversed version of Japanese Kessler-6 scale, such that 24 was best.