著者

Akira Okada Hideo Yasunaga

出版者

Japan Medical Association / The Japanese Associaiton of Medical Sciences

雑誌

JMA Journal (ISSN:2433328X)

巻号頁・発行日

vol.5, no.2, pp.190-198, 2022-04-15 (Released:2022-05-16)

参考文献数

13

被引用文献数

7

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Introduction: Noncommunicable diseases (NCDs) are an ongoing public health problem globally. The present study aimed to estimate the prevalence of NCDs in Japan using a newly developed, commercially available administrative claims database covering young, middle-aged, and elderly people.Methods: We compared the age-stratified population distribution between the DeSC administrative claims database and the population estimates. We calculated the 1 year prevalence of several NCDs using the DeSC database and compared the prevalence of diabetes mellitus and hypertension between the DeSC database and the Japan National Health and Nutrition Survey.Results: The age distribution of the population included in the DeSC database was similar to that of the population estimates. The estimated prevalence rates were as follows: diabetes mellitus (12.2%), hypertension (20.9%), ischemic heart disease (5.6%), heart failure (5.3%), cerebral infarction (3.4%), stroke (3.7%), gastric cancer (0.6%), colorectal cancer (0.8%), breast cancer (1.5%), prostate cancer (0.6%), cataract (7.1%), depression (3.5%), and osteoporosis (6.3%). The estimated prevalence of diabetes and hypertension was comparable with that of the National Health and Nutrition Survey.Conclusions: The distribution of age and sex in the database was comparable with that of the population estimates. The prevalence of diabetes mellitus and hypertension was comparable with that in a previously reported national survey. Our data can be utilized as basic information for policymaking in clinical medicine and public health in Japan.

著者

Atsushi Mizuno Hidehiro Kaneko Yuta Suzuki Akira Okada Norifumi Takeda Hiroyuki Morita Katsuhito Fujiu Koichi Node Hideo Yasunaga Issei Komuro

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0292, (Released:2023-06-30)

参考文献数

13

被引用文献数

1

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Background: The applicability of the Stages of Change model for cardiovascular disease-related behaviors, such as smoking, exercise, diet, and sleep quality, is unclear.Methods and Results: Using a large-scale epidemiological dataset, we found that baseline behavior change intention, as per the transtheoretical model, was associated with modifications of unhealthy lifestyles including cigarette smoking, physical inactivity, skipping breakfast, and poor sleep quality.Conclusions: Our results suggest that an individual’s motivation to change assessed by a general questionnaire may contribute to lifestyle modification and potentially prevent subsequent cardiovascular disease.

著者

Hayato Yamana Akira Okada Sachiko Ono Nobuaki Michihata Taisuke Jo Hideo Yasunaga

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220089, (Released:2023-01-14)

参考文献数

15

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Background: Despite the widespread practice of Japanese traditional Kampo medicine, the characteristics of patients receiving various Kampo formulations have not been documented in detail. We applied a machine learning model to a health insurance claims database to identify the factors associated with the use of Kampo formulations.Methods: A ten-percent sample of enrollees of the JMDC Claims Database in 2018 and 2019 was used to create the training and testing sets, respectively. Logistic regression with lasso regularization were performed in the training set to construct models with prescriptions of 10 commonly used Kampo formulations in one year as the dependent variable and data of the preceding year as independent variables. Models were applied to the testing set to calculate the C-statistics. Additionally, the performance of simplified scores using 10 or 5 variables were evaluated.Results: There were 338,924 and 399,174 enrollees in the training and testing sets, respectively. The commonly prescribed Kampo formulations included kakkonto, bakumondoto, and shoseityuto. Based on the lasso models, the C-statistics ranged from 0.643 (maoto) to 0.888 (tokishakuyakusan). The models identified both the common determinants of different Kampo formulations and the specific characteristics associated with particular Kampo formulations. The simplified scores were slightly inferior to full models.Conclusions: Lasso regression models showed good performance for explaining various Kampo prescriptions from claims data. The models identified the characteristics associated with Kampo formulation use.

著者

Hayato Yamana Sachiko Ono Akira Okada Taisuke Jo Hideo Yasunaga

出版者

Japan Society for Occupational Health

雑誌

Journal of Occupational Health (ISSN:13419145)

巻号頁・発行日

vol.62, no.1, pp.e12183, 2020 (Released:2021-01-25)

参考文献数

17

被引用文献数

3

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Objectives: It is unclear whether mandatory health examination is effective for employees who are already being treated for chronic diseases. We focused on patients being treated for hypertension and evaluated the association between employer-based health examination attendance and diabetes treatment initiation.Methods: Using a database that stores health insurance claims and health examination results of subscribers enrolled in society-managed health insurance plans in Japan, we identified employees aged 40-59 years who were being treated for hypertension when starting diabetes treatment from April 2012 to December 2016. A case-crossover analysis was conducted using 90, 180, and 270 days prior to diabetes treatment initiation as reference points and 90 days after the mandatory health examination as the exposure period. We conducted a subgroup analysis by hemoglobin A1c (HbA1c) level and frequency of outpatient blood glucose testing before the mandatory health examination.Results: We identified 1464 individuals starting treatment for diabetes while on antihypertensive drugs. The overall odds ratio for starting diabetes treatment within 90 days of the health examination was 1.89 (95% confidence interval: 1.70-2.10). The subgroup analysis showed that this odds ratio increased as HbA1c level increased and as blood glucose testing frequency decreased.Conclusions: Among employees starting treatment for diabetes while being treated for hypertension, employer-based mandatory health examination attendance was associated with initiation of diabetes treatment. The health examinations may be functioning as a complement to screening in outpatient settings.

著者

KUNIO KAWAMATA AKIRA OKADA

出版者

JAPANESE ECONOMIC ASSOCIATION

雑誌

The Economic Studies Quarterly (ISSN:0557109X)

巻号頁・発行日

vol.42, no.4, pp.289-291, 1991-12-20 (Released:2007-10-19)

著者

AKIRA OKADA KENICHI SAKAKIBARA

出版者

JAPANESE ECONOMIC ASSOCIATION

雑誌

The Economic Studies Quarterly (ISSN:0557109X)

巻号頁・発行日

vol.42, no.4, pp.315-333, 1991-12-20 (Released:2007-10-19)

参考文献数

6

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This paper discusses how a democratic state can emerge as a result of a social contract and how it evolves dynamically in a society with a public good that confronts the Prisoners' Dilemma. Individuals of the society play a game of institutional arrangements to establish a state in which there are two classes: an enforcer who collects tax and has punishing power and enforcees who pay tax. Our main result is that the state emerges with a positive probability if and only if the productivity of the society is lower than a certain level which is determined by the population and the marginal productivity of the public good, and that the state will disappear as soon as the productivity becomes greater than this critical level.