Relationship between Health-Seeking Behavior by Basic Health Examination and Subsequent Health Expenditure among Remote Island Inhabitants of Japan

BACKGROUND Convincing evidence has not been obtained as to whether having a basic health examination in the prime of life inhibits the surge of health expenditure in old age. METHODS DATA SOURCES Data on participants in the basic health examination from 1996 to 2000 among residents of a remote island in Japan, and individual health care expenditure data from March 2005 to February 2008. STUDY DESIGN A community-based retrospective study. DATA COLLECTION Japanese residents who were subscribers to the National Health Insurance Scheme of Chibu Town from March 1996 to March 2007 and were aged 40 to 64 years in March 1996 (n = 179) were divided into 3 groups depending on the frequency of participating in the basic health examination over 5 years: 0 times (nontakers), 1 to 3 times (occasional takers), or 4 to 5 times (regular takers). The distribution of total health expenditure according to the frequency of having a basic health examination was determined, and the Cochrane-Armitage test was used for comparison. RESULTS Nontakers formed the highest proportion of subjects with low expenditure (0-200,000 yen) (nontaker, occasional, regular: 38.5%, 24.1%, 23.5%; P = 0.002), and also accounted for the highest proportion of subjects with high expenditure (> 1,400,000 yen) (33.3%, 16.1%, 9.4%; P = 0.004). CONCLUSION Persons not participating in health examinations during middle age include a group with high future health care expenditure.