PHS95 - Assessing a Physician visit for Hepatic Dysfunction based on database merging claims and Annual Health Checkup data in Japan

Abstract

Objective of this study is to assess a trend of physician visit among individuals who were detected as hepatic dysfunction by the annual health checkup (Kenshin) which is implemented in Japan. This is a retrospective cohort study using Japan Medical Data Center (JMDC) database. Annual health checkup data in 2012 and the associated claims data were merged by unique identifiers. Individuals (18≤age≤64) with ALT>30(IU/L) as hepatic dysfunction were identified. The proportion of individuals who visited a physician office after the annual health checkup for liver related diagnosis up to month 3,6,9 and 12 from the date of the annual health checkup was evaluated. The number of visits associated with liver related diagnosis and confirmed diagnosis with liver-related disease by gender and age was assessed. The cox proportional hazard regression model was used to evaluate variables associated with a physician visit. 353,384 individuals were received hepatic function tests at the annual health checkup in 2012. 57,059 individuals were identified ALT>30(IU/L) without any liver related diagnosis in preceding 12 months of the annual health checkup. Among them, the cumulative proportion of individuals who visited physician office was 4%(month 3), 11%(month 6), 20%(month 9), and 30%(month 12). 4,379(8%) of individuals were confirmed with liver related diagnosis at month 12. Fatty liver was major diagnosis followed by alcoholic hepatic disease, virus hepatitis, hepatic fibrosis or cirrhosis and liver cancer. Individuals with higher ALT values, older age, and female are more likely to visit physician’s office after the annual health checkup. One in six individuals was newly detected with hepatic dysfunction at the annual checkup. Despite of the serious consequence of liver related diseases, small number of individuals with hepatic dysfunctions detected by the annual health checkup visited physician office for further evaluation of the diagnosis.