C-reactive protein (CRP) is a predictor of high medical-care expenditures in a community-based elderly population aged 70 years and over: The Tsurugaya project

Kaijun Niu, Atsushi Hozawa, Hui Guo, Kaori Ohmori-Matsuda, Yufei Cui, Satoru Ebihara, Naoki Nakaya, Shinichi Kuriyama, Toru Tsuboya, Masako Kakizaki, Takashi Ohrui, Hiroyuki Arai, Ichiro Tsuji, Ryoichi Nagatomi

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Abstract

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.

Original languageEnglish
Pages (from-to)e392-e397
JournalArchives of Gerontology and Geriatrics
Volume54
Issue number3
DOIs
Publication statusPublished - 01-05-2012

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Health Expenditures
C-Reactive Protein
medical care
expenditures
Population
community
Independent Living
hospitalization
Hospitalization
Outpatients
National Health Programs
health insurance
Inpatients
regression analysis
Cohort Studies
Logistic Models
logistics
Regression Analysis
Prospective Studies
Disease

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Ageing
  • Gerontology
  • Geriatrics and Gerontology

Cite this

Niu, Kaijun ; Hozawa, Atsushi ; Guo, Hui ; Ohmori-Matsuda, Kaori ; Cui, Yufei ; Ebihara, Satoru ; Nakaya, Naoki ; Kuriyama, Shinichi ; Tsuboya, Toru ; Kakizaki, Masako ; Ohrui, Takashi ; Arai, Hiroyuki ; Tsuji, Ichiro ; Nagatomi, Ryoichi. / C-reactive protein (CRP) is a predictor of high medical-care expenditures in a community-based elderly population aged 70 years and over : The Tsurugaya project. In: Archives of Gerontology and Geriatrics. 2012 ; Vol. 54, No. 3. pp. e392-e397.
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abstract = "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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Niu, K, Hozawa, A, Guo, H, Ohmori-Matsuda, K, Cui, Y, Ebihara, S, Nakaya, N, Kuriyama, S, Tsuboya, T, Kakizaki, M, Ohrui, T, Arai, H, Tsuji, I & Nagatomi, R 2012, 'C-reactive protein (CRP) is a predictor of high medical-care expenditures in a community-based elderly population aged 70 years and over: The Tsurugaya project', Archives of Gerontology and Geriatrics, vol. 54, no. 3, pp. e392-e397. https://doi.org/10.1016/j.archger.2012.01.014

C-reactive protein (CRP) is a predictor of high medical-care expenditures in a community-based elderly population aged 70 years and over : The Tsurugaya project. / Niu, Kaijun; Hozawa, Atsushi; Guo, Hui; Ohmori-Matsuda, Kaori; Cui, Yufei; Ebihara, Satoru; Nakaya, Naoki; Kuriyama, Shinichi; Tsuboya, Toru; Kakizaki, Masako; Ohrui, Takashi; Arai, Hiroyuki; Tsuji, Ichiro; Nagatomi, Ryoichi.

In: Archives of Gerontology and Geriatrics, Vol. 54, No. 3, 01.05.2012, p. e392-e397.

Research output: Contribution to journalArticle

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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

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