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Effects of the increase in co-payments from 20 to 30 percent on the compliance rate of patients with hypertension or diabetes mellitus in the Employed Health Insurance System

Published online by Cambridge University Press:  26 April 2005

Akira Babazono ,
Motonobu Miyazaki ,
Takuya Imatoh ,
Hiroshi Une ,
Eiji Yamamoto ,
Toshihide Tsuda ,
Kiyoshi Tanaka  and
Shinichi Tanihara
Akira Babazono
Affiliation:
Kyushu University
Motonobu Miyazaki
Affiliation:
Fukuoka University
Takuya Imatoh
Affiliation:
Fukuoka University
Hiroshi Une
Affiliation:
Fukuoka University
Eiji Yamamoto
Affiliation:
Okayama University of Science
Toshihide Tsuda
Affiliation:
Okayama University
Kiyoshi Tanaka
Affiliation:
Japan Health Food and Nutritional Food Association
Shinichi Tanihara
Affiliation:
Shimane University
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Abstract

Objectives: How to contain medical expenditures is a universal problem. The Japanese government has increased patient co-payments to control it. The purpose of this study is to clarify whether the increase in co-payments to 30 percent prevented patients with hypertension or diabetes mellitus from receiving necessary care in the Employee Health Insurance System.

Methods: The subjects were 211 patients with hypertension and 66 patients with diabetes mellitus who regularly visited physicians from October 2001 to March 2002 and were defined as a cohort that needed health care, and their medical indicators were examined between April and September 2002 (prestage) and between April and September 2003 (poststage).

Results: In the hypertensive patients with no complications, the compliance rate was 89.9 percent and 88.0 percent in the prestage, and poststage, respectively, showing no significant change. In the hypertensive patients with complications, the compliance rate was 90.5 percent and 92.1 percent in the prestage and poststage, respectively, showing no significant change. In the diabetic patients with complications, the compliance rate was 77.5 percent and 79.2 percent, in the prestage and poststage, respectively, with no significant change. In the diabetic patients with no complications, however, the compliance rate was 83.7 percent and 66.7 percent, in the prestage and poststage, respectively. A significant decrease was observed among diabetic patients without complications.

Conclusions: Increasing co-payments reduced necessary preventive care in diabetic patients without complications.

Keywords

Co-paymentsComplianceHypertensionDiabetes mellitusHealth policy
Type
RESEARCH REPORTS
Information
International Journal of Technology Assessment in Health Care , Volume 21 , Issue 2 , April 2005 , pp. 228 - 233
Copyright
© 2005 Cambridge University Press

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References

Anderson GM, Brook R, Williams A. 1991 A comparison of cost-sharing versus free care in children: effects on the demand for office-based medical care. Med Care. 29: 890– 898.Google Scholar
Babazono A. 1990 The impact of partial cost sharing on the attitude of insured persons with hypertension. Nippon Eiseigaku Zassi. 45: 849– 859 (in Japanese).Google Scholar
Babazono A, Ogawa T, Babazono T, et al. 1991 The effect of a cost sharing provision in Japan. Fam Pract. 8: 247– 252.Google Scholar
Babazono A, Weiner J, Tsuda T, Mino Y, Hillman AL. 1998 The effect of a redistribution system for elderly health care on the finance performance of Health Insurance Societies in Japan. Int J Technol Assess Health Care. 14: 458– 466.Google Scholar
Babazono A, Tsuda T, Mino Y, Miyazaki M, Une H. 2002 The effect for patients with hypertension and diabetes mellitus on physician visits by increase in patient co-payments. Jpn J Public Health. 49: 10: 321 (in Japanese).Google Scholar
Babazono A. The effect of introduction of 20 percent co-payments on visits to physicians. Scientific report for a grant-in-aid for scientific research from the Japan Ministry of Education, Science and Culture, Fukuoka, 2002 (in Japanese).
Babazono A, Tsuda T, Yamamoto E, Mino Y, Une H, Hillman AL. 2003 Effects of an increase in patient co-payments on medical service demands of the insured in Japan. Int J Technol Assess Health Care. 19: 465– 475.Google Scholar
Babazono A, Miyazaki M, Une H, et al. 2004 A study on a reduction in visits to physicians after introduction of 30 percent co-payments in the Employee Health Insurance in Japan. Indust Health. 42: 50– 56.Google Scholar
Folland S, Goodman AC, Stano M. 2001. The economics of health and health care. Upper Saddle River, NJ: Prentice Hall;
Keeler EB, Rolph JE. 1983 How cost sharing reduced medical spending of participants in the health insurance experiment. JAMA. 249: 484– 490.Google Scholar
Kubota M, Babazono A, Aoyama H. 2000 Women's anxiety in old age and long-term care provision for the elderly. Acta Med Okayama. 54: 75– 83.Google Scholar
Lohr KN, Brook RH, Kamberg CJ, et al. 1986 Use of medical care in the Rand Health Insurance Experiment: Diagnosis- and service-specific analyses in a randomized controlled trial. Med Care. 24: 72– 87.Google Scholar
2000 Ministry of Health and Welfare (MHW), Japan. Hoken to Nenkin no Doko, Tokyo: Health and Welfare Statistics Association; (in Japanese).
2000 Ministry of Health and Welfare (MHW), Japan. Kokumin Eisei no Doko, Tokyo: Health and Welfare Statistics Association; (in Japanese).
Newhouse JP, Manning WG, Morris CN, et al. 1981 Some interim results of a controlled trial of cost sharing in health insurance. N Engl J Med. 305: 1501– 1507.Google Scholar
O'Gray KF, Manning WG, Morris CN, et al. 1985 The impact of cost sharing on emergency department use. N Engl J Med. 313: 484– 490.Google Scholar
Rothman KJ, Greenland S. 1998. Modern epidemiology. Philadelphia: Lippincott-Raven Publisher;
Selby JV, Frieman BH, Swain BE. 1986; Effect of a copayment on use of the emergency department in a health insurance organization. N Engl J Med. 334: 635– 641.Google Scholar
Shapiro MF, Ware JE, Sherbourne CD. 1986 Effects of cost sharing on seeking care for serious and minor symptom: Results of a randomized controlled trial. Ann Intern Med. 104: 246– 251.Google Scholar
Shekelle PG, Rogers WH, Newhouse JP. 1996 The effect of cost sharing on the use of chiropractic services. Med Care. 34: 863– 872.Google Scholar