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ABSTRACT: To determine the prevalence of comorbid depression among people with type 2 diabetes using the integrated health database.
A total of 6543 people aged 18-65 years were selected from the employees of a Japanese corporation. Using the corporation's integrated health database, which consisted of medical claims data and a self-reported questionnaire from the fiscal year 2000, this study was undertaken to identify the prevalence, the odds ratio and some related factors.
The prevalence of co-morbid depression among people with type 2 diabetes was 2.6%. The crude odds ratio of co-morbid depression among those with type 2 diabetes was 2.20 (95% CI 0.88-5.50). After adjustment for covariates (gender, age, alcohol drinking, smoking, exercise, and dietary restriction), the odds ratio of co-morbid depression among those with type 2 diabetes was 2.33 (0.86-6.33).
Using the integrated health database, it was suggested that patients with type 2 diabetes were more likely to suffer from depression and there was a relationship between depression and dietary restriction of portion control.
Journal of medical and dental sciences 03/2007; 54(1):39-48.
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ABSTRACT: In Japan, the emergency medical system is categorized into three levels: primary, secondary, and tertiary, depending on the severity of the condition of the patient. Tertiary care centres accept patients who require 24-h monitoring. In this research, the average travel times (minutes) from the centroids of all municipalities in Japan to the nearest tertiary care centre were estimated, using the geographic information system. The systems affecting travel time to tertiary care centres were also examined. Regression analysis was performed to determine the factors affecting the travel time to tertiary care centres, using selected variables representing road conditions and the emergency transfer system. Linear regression analysis was performed to identify specific benchmarks that would be effective in reducing the average travel time to tertiary care centres in prefectures with travel times longer than the average 57 min.
The mean travel time was 57 min, the range was 83 min, and the standard deviation was 20.4. As a result of multiple regression analysis, average coverage area per tertiary care centre, kilometres of highway road per square kilometre, and population were selected as variables with impact on the average travel time. Based on results from linear regression analysis, benchmarks for the emergency transfer system that would effectively reduce travel time to the mean value of 57 min were identified: 26% pavement ratio of roads (percentage of paved road to general roads), and three tertiary care centres and 108 ambulances.
Regional gaps in the travel time to tertiary care centres were identified in Japan. The systems we should focus on to reducing travel time were identified. Further reduction of travel time to tertiary care centres can be effectively achieved by improving these specific systems. Linear regression analysis showed that a 26% pavement ratio and three tertiary care centres are beneficial to prefectures with an average time longer than the mean score, to achieve a reduction of travel time. Measures for reducing travel time need to be considered in policy-making to re-evaluate the current locations of tertiary care centres to provide equality of access to emergency medicine.
International Journal of Health Geographics 02/2006; 5:25. · 2.62 Impact Factor
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ABSTRACT: This study examined the differences in medical care costs among (1) individuals who carried the diagnosis of selected lifestyle diseases (diabetes mellitus, hypertension, and hyperlipidemia), (2) individuals whose levels of risks (blood glucose, blood pressure, and total cholesterol) satisfied the diagnosis guidelines yet who did not carry the diagnoses, (3) individuals who had these risks but whose risk levels were not high enough to satisfy the diagnosis guidelines, and (4) individuals without the risks.
A one-time cross-sectional design was used. Health checkup data and medical-claims data obtained from the fiscal year 2000 were examined for correlations.
A total of 3292 employees aged 34 years and older were selected from the entire employee population of 6543 in a Japanese corporation. Employees younger than 34 years old were excluded because their clinical risk data were not available.
On the basis of their absence or presence of diagnoses (obtained from medical claims) and underlying risk levels (obtained from health checkups), employees were categorized into (1) the diagnosed group, (2) the extremely high-risk group, (3) the high-risk group, or (4) the no-risk group. Reimbursement points on medical care claims were summed for each individual during the study period and multiplied by 10 to calculate the total medical care costs, as each point in the reimbursement request form represents 10 yen.
The high-cost case analysis was used. First, the high costs were determined as the costs at or above the 90th percentile. The diagnosis or risk status was examined in its relation to the newly created dichotomous variable (whether the medical costs were at or above the threshold or were lower than the threshold) by using a chi2 test. Furthermore, excluding the diagnosed group, a chi2 test was performed to examine the relationships between the levels of risk and the likelihood of incurring any medical care costs (use vs. nonuse).
Approximately 15% of employees were already diagnosed with at least one of the three diseases (the diagnosed group; n = 490). One-quarter of employees had at least one risk that was high enough to be diagnosed with the corresponding disease if they had sought medical care (the extremely high-risk group; n = 809). There were 1343 employees in the high-risk group and 650 employees in the no-risk group. The diagnosed group had much higher chances of incurring medical care costs at or above the 90th percentile than did any other risk or no-risk group. No difference among the three risk or no-risk groups was found in mean medical care costs or in the likelihood of any use of medical care services after controlling for the effect of diagnosis.
In a Japanese employee population, the diagnosis status of diabetes mellitus, hyperlipidemia, and hypertension was found to be associated with higher medical care costs while risk levels for the diseases were not in a 1-year time period.
American journal of health promotion: AJHP 19(3 Suppl):249-54. · 2.37 Impact Factor
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ABSTRACT: Comparing the group of overtime work with non-overtime work, the percentages of employees in each group who had stress feelings were not statistically different. Meanwhile, the percentage of employees who had outlying observations was statistically higher in the group of overtime work than non-overtime work (p < 0.05).
International Congress Series.
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ABSTRACT: A case study was undertaken to identify the situation of occupational health services (OHS) practices through the Internet, which included health consultation and health guidance. Regardless of the corporation size, the numbers of employees who had taken use of OHS through the Internet were close. Meanwhile, the employees' usage of health consultation and guidance in the smaller corporation tended to be more frequent than that in the larger one.
International Congress Series.
