Presentation (CTI)

OBJECTIVES: Since 2008, Standardized Health Training (SHT) has been offered to members of Japan's national health insurance system along with Standardized Health Check-ups (SHC). SHT helps people at risk for metabolic syndrome prevent lifestyle-related diseases through behavioral changes. We have already shown in [Ueda] that the Return on Investment of SHT exceeds 1 using Real World Data owned by Nippon Life, Wellness-Star☆. Although SHT is standardized, there are also differences among providers, both in detail and in cost. These differences may alter the effectiveness of SHT. In this study, we estimated the magnitude of the differences.
METHODS: From that database, those who received SHT were selected and matched with those who did not receive SHT on the following factors: gender, age, baseline medical expenses, metabolic judgement, and health training level. On a yearly basis from SHT, the per member per month medical cost was calculated for both the intervention group and the control group, and the difference was defined as ΔPMPM. ΔPMPM was calculated for each health insurance society, and its distribution was estimated. The distribution was calculated separately for Proactive Support (PS) and Motivational Support (MS).
RESULTS: The database had 4.9million insured persons. Of these, 175,263 had received SHT. The matching resulted in 128,803 and 956,217 insureds in the intervention and control groups, respectively. ΔPMPM was calculated for 171 health insurance societies. The means and standard deviations were 2,608 JPY and 8,809 JPY for PS and 1,666 JPY and 8,144 JPY for MS.
CONCLUSIONS: In both PS and MS, the average medical cost reduction was positive, but some health insurance associations have negative medical cost reductions due to large standard deviations.Reference: [Ueda] Return on Investment of National Standardized Health Training in Japan - a Cohort Study Using “Wellness-Star☆” Health Insurance Claims Database. ISPOR Europe 2024.