Different rates of acceptance of health examination among the people under 2 separate health insurance programs in Japan.

The entire population in Japan is covered by either workplace-based health insurance program or region-based health insurance program. While both programs were originally for curative medical care, only the former program has recently extended its financial support to preventive health examination. The attitude of the people toward health examination was studied in Miyagi prefecture in north-east Japan by questionnaires with more than 32,000 respondents to examine whether the difference in health insurance reflect on the rates of acceptance of 4 health examination items (i.e., blood pressure measurement, chest x-ray taking, and 2 screening tests for stomach and cervical cancer). Throughout the 4 items, the rate of acceptance was higher among those who were covered by workplace-based health insurance than among those covered by regional health insurance. The difference is large for the insured and less so for the family dependents of the insured. Further analysis for the preferred opportunities for health examination such as personal examination at clinics in contrast to region-based mass examination showed that the weight of clinics was quite large for the insured of national health insurance and their family dependents (i.e., 50% or even larger) but it was less so for the people covered by workplace-based insurance.