Moshiur Rahman

An Investigation of Factors Influencing High Usage of Medical and Long-Term Care Services in an Aging Society in Japan:

Medical and long-term care costs are increasing all over the world. In this study, we investigated the characteristics of groups with high cost of medical and long-term care to define targets for curbing social security costs. As a result, for the population covered by the National Health Insurance, a large portion of medical costs were incurred for mental disorders, malignant neoplasms, and lifestyle-related diseases. For those covered by the Late Elderly Health Insurance System, most medical costs were incurred for lifestyle-related diseases, femoral fractures, neurological diseases, mental disorders, pneumonia, malignant neoplasms, and Alzheimer’s disease. From multiple regression analysis, the hospitalization days, use of advanced medical treatment, outpatient days, and high long-term care level influenced the increased costs. On the other hand, disease characteristics had only a very low effect. These findings suggest that the target population has complex medical and long-term care needs because they have multiple diseases.

712 Relevant factors of health and productivity management progress in small and medium-sized enterprises: a questionnaire survey for enterprises’ presidents

Introduction Although health and productivity management (HPM) is an important concept regardless of company size, there is a difference in recognition and degree of practice about HPM between small and medium-sized enterprises (SME) and large enterprises. The purpose of this study was to explore the factors related to the practical progress of HPM among SME’s presidents. Methods Anonymous self-administered questionnaire was conducted. The questionnaire was consisting of two parts. Part 1 was about the enterprises, types of industries, capital amount, and the enterprises’ presidents (age and period of position). Part 2 included behaviour modification strategies, developed based on four levels of changes proposed by Hersey and Blanchard and five stages of behaviour changes by Prochaska and DiClemente. JMP® 12 (SAS Institute Inc., Cary, NC, USA) was used to analyse the data. Results The questionnaire was completed by presidents of 22 SME’s aged between 30 years to 70 years. Their industries were mainly 6 kinds: construction, service, manufacturing, transportation and communication, electricity/gas/water service and real estate industry, and 2 others. In part 1, there was no significant correlation between stages of behaviour change about HPM and enterprise’s basic information (for example, industry, capital amount, age of presidents, or period as a president). In part 2, there was significant middle correlation between stages of behaviour change about HPM and states of having knowledge about HPM (correlation coefficient: 0.65, p<0.01), or attitude to practice HPM (0.61, <0.01). On the other hand, it was unclear whether there was a correlation between the stages and president’s personal practice of health promotion (0.27, p=0.24). Conclusion This study showed that the correlation factors to HPM’s progress could be strengthened by occupational health support. As the next step, we need to consider how to provide information and motivate to the enterprises’ presidents.

Workers’ sleep condition and related disorders in Japan: an analysis based on health insurance claim data and questionnaire

The purpose of this study was to clarify the sleep disorders and sleep conditions among workers in a company through descriptive statistics. We analyzed the data of individuals with suspected sleep disorders based on the 1-year outpatient health insurance claim data of 2803 employees in a company in Japan. We conducted a questionnaire survey to determine the sleep condition and drug usage of the same participants. Claim data of 339 employees (12.1%) were selected for analysis, and the breakdown of diseases comprised 153 (5.5%) with sleep disorders, 149 (5.3%) with headache, 119 (4.2%) with depression and 17 (0.6%) with autonomic imbalance. We recovered 2608 questionnaire responses (93.0%) and found that 1852 subjects (71.0%) were aware of insomnia symptoms within 1 year. Our findings highlight the prevalence of sleep disorders and drug usage among workers in a company, and the conditions of these disorders, including awareness of insomnia.