OBJECTIVES: The increase of healthcare expenditure is more serious for local governments in rural area, because of lower tax revenue and rapid population aging. Hirosaki University started a checkup in 2005 in Iwaki Town located in Aomori Prefecture, northern side of Japan, which shows the worst mortality rate in Japan over a few decades, and established Center of Healthy Aging Innovation (COI) program in 2013 for enlightening residents based on checkup results. The aim of this study is evaluating the effect of COI program on the prevention of stroke or cardiovascular disease (CVD) and estimating the medical cost reduction.

METHODS: Using checkup data from 2009 to 2016, risk-scores corresponding to 10-years incidence rate of stroke or CVD were calculated for all subjects in each year. The multivariate models were constructed for explaining the distribution of risk-scores from 2010 to 2012 (“before COI”) and from 2012 to 2016 (“after COI”). Applying two models to data in 2010, we predicted the distribution of risk-scores in 2017 and the incidence of stroke or CVD in the following 10-years.

RESULTS: For both stroke and CVD, the distribution of risk-scores improved in “after COI model”. The numbers of stroke/CVD onsets under "after COI" model were decreased for 32 (48 vs. 80) and 63 (27 vs. 90) compared to "before COI" model in 10 years. For the whole population of Aomori prefecture, the introduction of COI program can avoid 6,329 (9,583 vs. 15,912) and 11,470 (5,238 vs. 16,708) patients from stroke/CVD, with the saving of JPY19.6bil. for medical costs within 10 years.

CONCLUSIONS: Due to COI program, the incidence of severe diseases with high medical cost was predicted to decrease. For local governments in the Japanese rural area, this program is considered to be an effective solution.