Rate of health insurance reimbursement and adherence to anti-hypertensive treatment among Japanese patients

Akihito Hagihara, Masayoshi Murakami, Akiko Chishaki, Fumikazu Nabeshima, Koichi Nobutomo

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Although several studies have reported the effects of free medical care on compliance in patients with hypertension, no study has reported the effects of an economic incentive, such as subsidized medical costs, on compliance with medication protocol, in patients with hypertension. The unique characteristics of the Japanese health insurance system provide for a 10% decrease in the subsidy for medication immediately on retirement (approximately 60 years of age) for insured patients, and a 100% subsidy for insured patients who are 70 years of age or older. We examined the association between level of health insurance coverage and follow-up rate of medical treatment among Japanese patients with hypertension. Methods: The subjects, from throughout Japan, were patients with hypertension (n = 1236). The study was conducted in 1991. The odds of completing a 1-year treatment in relation to the rate of health insurance reimbursement were calculated using multiple logistic regression analysis. Results: We found the following. (1) Compared with the base group, the odds of completing a 1-year treatment increased to 2.62 or 2.51 in the group whose reimbursement rate was 100%. (2) Compared with the base group, the odds of completing a 1-year treatment was no larger than 1 in the group whose reimbursement rate had been 100% for more than 6 years ('76-'). (3) Compared with the base level, the odds of completing a 1-year treatment increased to 1-1.81 in the group whose liability decreased to 80%. Conclusion: Although the results imply that even a small economic incentive might be effective in securing a patient's compliance with anti-hypertensive medical treatment, the effect appear limited in both duration and magnitude.

Original languageEnglish
Pages (from-to)231-242
Number of pages12
JournalHealth Policy
Volume58
Issue number3
DOIs
Publication statusPublished - Oct 24 2001

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Health Insurance Reimbursement
Antihypertensive Agents
Hypertension
Health Insurance
Patient Compliance
Motivation
Therapeutics
Economics
Insurance Coverage
Medication Adherence
Retirement
Health Status
Japan
Logistic Models
Regression Analysis
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Health Policy

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Rate of health insurance reimbursement and adherence to anti-hypertensive treatment among Japanese patients. / Hagihara, Akihito; Murakami, Masayoshi; Chishaki, Akiko; Nabeshima, Fumikazu; Nobutomo, Koichi.

In: Health Policy, Vol. 58, No. 3, 24.10.2001, p. 231-242.

Research output: Contribution to journalArticle

Hagihara, Akihito ; Murakami, Masayoshi ; Chishaki, Akiko ; Nabeshima, Fumikazu ; Nobutomo, Koichi. / Rate of health insurance reimbursement and adherence to anti-hypertensive treatment among Japanese patients. In: Health Policy. 2001 ; Vol. 58, No. 3. pp. 231-242.
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