OBJECTIVES: The Center of Healthy Aging program (CHAP) to raise health awareness in a rural population reduced the risk of coronary heart diseases (CHDs) and stroke and then medical costs in the long-term in a Japanese rural area, Hirosaki city. The aim of this study was to assess the association of daily habits with the reduction of medical and care costs in addition to the participation of the CHAP.

METHODS: We included all residents registered in Hirosaki city before July 2015 and analyzed the claims data from July 2015 to March 2020 (follow-up period), the result of annual standard health checkups and CHAP-specific checkups from July 2014 to June 2015. We compared total medical and care costs in the follow-up period between 3 groups: CHAP participants, residents with an annual standard health checkup (checkup group), and everyone else (no checkup group). We analyzed residents with > JPY 0 of medical or care costs using a Poisson regression model by adjusting age, sex, CHD risk score, and Carlson comorbidity index (CCI) collected in the latest checkup. As we used checkup results to calculate CHD risk scores, we applied a multiple imputation method for missing values in the no checkup group.

RESULTS: Total care costs in the CHAP participants and the checkup group were estimated as 0.869 and 0.967 times as much as the no checkup group. Higher level of care needed associated with higher costs. In the CHAP participants with results of a cognitive function test, exercise habits associated with 0.696 times lower medical and care costs, in addition to known risk factors such as higher cognitive function and lower CHD risk scores and CCI points.

CONCLUSIONS: Exercise habits as well as participating health programs including the CHAP and standard health checkups would reduce the long-term medical and care costs.