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International Journal of Epidemiology 2003;32:809-814
© International Epidemiological Association 2003

Health Services Research

Impact of walking upon medical care expenditure in Japan: the Ohsaki Cohort Study

Ichiro Tsuji1, Kohko Takahashi2, Yoshikazu Nishino1, Takayoshi Ohkubo3, Shinichi Kuriyama1, Yoko Watanabe1, Yukiko Anzai2, Yoshitaka Tsubono1 and Shigeru Hisamichi1

1 Department of Public Health, Tohoku University School of Medicine, Sendai, Japan.
2 Miyagi University School of Nursing, Sendai, Japan.
3 Department of Planning for Drug Development and Clinical Evaluation, Tohoku University School of Pharmaceutical Science, Sendai, Japan.

Dr Ichiro Tsuji, Department of Public Health, Tohoku University School of Medicine, 2–1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan. E-mail: tsuji1{at}mail.cc.tohoku.ac.jp

Background Physical activity is expected to reduce medical costs by lowering the risk for a variety of chronic diseases. However, little is known about the actual magnitude of medical cost saved by physical activity. We attempted to quantify the association between time spent walking and medical care costs, based on a 4-year prospective observation of National Health Insurance (NHI) beneficiaries in rural Japan.

Methods In 27 431 Japanese men and women, aged 40–79 years, who had no functional limitation or conditions interfering with physical activity at the baseline survey in 1994, we ascertained all hospitalizations, outpatient visits, and the costs through computerized linkage with NHI claims history files between January 1995 and December 1998.

Results Medical costs significantly reduced with longer time spent walking. Per capita medical cost was £111.80 per month (95% CI: 109.3, 114.2) in those who walked for <=30 minutes/day, £108.10 (95% CI: 105.7, 110.5) in those who walked for 30 minutes–1 hour, and £97.30 (95% CI: 95.5, 99.0) in those who walked for >=1 hour, after multivariate adjustment of potential confounders.

Conclusions This prospective study in Japan indicated that time spent walking was significantly associated with lower medical costs.

Keywords Cohort study, physical activity, walking, medical cost

Accepted 31 March 2003


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