[Relationship of utilization rate of health examination under the Elderly Act to medical expenditure and days of medical care for the elderly].

The aim of this study was to investigate the relationship of utilization rate of health examination to medical expenditure and days of medical care per insured person under the Elderly Act. The factors related with the utilization rate of health examination were also analyzed by multiple regression analysis. The material used in this analysis was the 1993 national health insurance data for all of the 3,252 municipalities of Japan. The main results were as follows: 1. The average medical expenditure and days of medical care among the municipalities declined in the increasing order of the three categories of utilization rate of health examination; municipalities with utilization rate of less than 30% being the highest, and those with 50% or more being the lowest. 2. The average medical expenditure and days of medical care among the municipalities with community health centers were smaller than those without. 3. Multiple regression analysis showed that utilization rate had a positive relationship to percentage of elderly, presence of community health center, public financial power index, and number of public health nurses per resident. It had a negative relationship to the population and the number of clinical beds per resident. The number of public health nurses per resident was the most significant factor related with the utilization rate (standardized partial regression coefficient = 0.32). These results suggest that increasing the utilization rate of health examination and the number of community health centers could serve to lower medical expenditure and days of medical care through the promotion of the health services provided by municipalities.