TY - JOUR
T1 - C-reactive protein (CRP) is a predictor of high medical-care expenditures in a community-based elderly population aged 70 years and over
T2 - The Tsurugaya project
AU - Niu, Kaijun
AU - Hozawa, Atsushi
AU - Guo, Hui
AU - Ohmori-Matsuda, Kaori
AU - Cui, Yufei
AU - Ebihara, Satoru
AU - Nakaya, Naoki
AU - Kuriyama, Shinichi
AU - Tsuboya, Toru
AU - Kakizaki, Masako
AU - Ohrui, Takashi
AU - Arai, Hiroyuki
AU - Tsuji, Ichiro
AU - Nagatomi, Ryoichi
N1 - Funding Information:
This study was supported by a Grant-in-Aid for Young Scientists (A) ( 21689018 ) from the Ministry of Education, Culture, Sports, Science and Technology of Japan , by Health Sciences Research Grants for Health Service ( H21-Choju-Ippan-001, H18-Choju-Ippan-014 ) from the Ministry of Health, Labour, and Welfare of Japan ; and the Japan Arteriosclerosis Prevention Fund .
PY - 2012/5
Y1 - 2012/5
N2 - Because CRP is a strong independent predictor of various diseases, it was hypothesized that CRP may be a useful predictor or treatment target for medical-care expenditures. The aim of this study was to investigate the relationship between CRP and medical-care expenditures in a community-dwelling elderly population. This prospective cohort study was conducted including 925 Japanese subjects aged ≥70 years. A high-sensitivity CRP assay was used by applying the nephelometric method. Hospitalizations, outpatient visits, and expenditures were ascertained through computerized linkage with claims lodged between August 2002 and March 2008 with the Miyagi National Health Insurance (NHI) Association. Since medical-care expenditures were not normally distributed, the category of high medical-care expenditures (>75th percentile of medical-care expenditures: inpatient expenditures >$494/month; outpatient expenditure >$522/month; total expenditures >$1103/month) was used to examine the relation of CRP levels with medical-care expenditures. Multiple logistic regression analysis was used to examine the relationship between CRP cutoff points (low concentrations: <1.0. mg/L; intermediate concentrations: 1.0-3.0. mg/L; or high concentrations: ≥3.0. mg/L) and medical-care expenditures during 6 year-follow up period. After adjustment for potential confounding factors, a positive association of CRP with hospitalization, and total expenditures (p for trend = 0.03 and 0.02, respectively) was found. An elevated baseline CRP level is an independent predictor of increases in prospective medical-care expenditures among community-dwelling elderly. Further study is required to clarify whether reducing CRP by intervention is a cost-effective measure.
AB - Because CRP is a strong independent predictor of various diseases, it was hypothesized that CRP may be a useful predictor or treatment target for medical-care expenditures. The aim of this study was to investigate the relationship between CRP and medical-care expenditures in a community-dwelling elderly population. This prospective cohort study was conducted including 925 Japanese subjects aged ≥70 years. A high-sensitivity CRP assay was used by applying the nephelometric method. Hospitalizations, outpatient visits, and expenditures were ascertained through computerized linkage with claims lodged between August 2002 and March 2008 with the Miyagi National Health Insurance (NHI) Association. Since medical-care expenditures were not normally distributed, the category of high medical-care expenditures (>75th percentile of medical-care expenditures: inpatient expenditures >$494/month; outpatient expenditure >$522/month; total expenditures >$1103/month) was used to examine the relation of CRP levels with medical-care expenditures. Multiple logistic regression analysis was used to examine the relationship between CRP cutoff points (low concentrations: <1.0. mg/L; intermediate concentrations: 1.0-3.0. mg/L; or high concentrations: ≥3.0. mg/L) and medical-care expenditures during 6 year-follow up period. After adjustment for potential confounding factors, a positive association of CRP with hospitalization, and total expenditures (p for trend = 0.03 and 0.02, respectively) was found. An elevated baseline CRP level is an independent predictor of increases in prospective medical-care expenditures among community-dwelling elderly. Further study is required to clarify whether reducing CRP by intervention is a cost-effective measure.
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U2 - 10.1016/j.archger.2012.01.014
DO - 10.1016/j.archger.2012.01.014
M3 - Article
C2 - 22365588
AN - SCOPUS:84859846906
SN - 0167-4943
VL - 54
SP - e392-e397
JO - Archives of Gerontology and Geriatrics
JF - Archives of Gerontology and Geriatrics
IS - 3
ER -