Relationship of health services to medical expenses for the national health insurance and certification rate for long-term care insurance services in municipalities.

Abstract

In many municipalities, implementation rates of health services mandated by the Health and Medical Service Law for the Elderly have not reached the national goal that was set at the start. This study aimed to evaluate the effects of health services using medical expenses for the National Health Insurance (NHI) and certification rate for long-term care insurance services in 99 municipalities in Gifu Prefecture as indices. Both indices were standardized by the age composition of the population. Among the health services, visit rates for health examinations or implementation rates for health education or health counseling correlated negatively with medical expenses for each insured person. The visit rate for gastric cancer screening correlated negatively with medical expenses for malignant neoplasms of the stomach. Implementation rates of health education or health counseling, or ratios of public health nurses correlated positively with certification rates for long-term support need and care need grade 1, and negatively with those for long-term care need grades 2, 3, and 4. The author concluded that medical expenses are reduced by the implementation of available health services, that early detection and prevention of aggravation of disease is essential for those who need long-term care services, and that health services must be reinforced with primary prevention.