Behavioral change in outcome evaluation of the 4th phase of specific health checkups and specific health guidance

Abstract

In the fourth phase of the Specific Health Checkups and Specific Health Guidance, which commenced in 2024, outcome evaluation, including behavioral change in addition to a reduction in abdominal circumference and body weight, has been newly introduced. The Specific Health Guidance is designed to prevent the future onset of lifestyle-related diseases, with the additional objective of reducing medical expenses. In the discussions on the revision of the fourth-stage specific health checkups and specific health guidance, the introduction of outcome evaluation was generally viewed favorably. However, it was also suggested that the responsibility of insurers to deliver results from specific health guidance might impact the system. With this revision, outcome evaluation will be conducted in stages, in conjunction with behavioral changes. However, concerns have been raised regarding the feasibility of having insurers objectively assess behavioral change as a duty, and the discrepancy between the objective of specific health guidance and the aforementioned assessment. Nevertheless, the opinion that evaluating behavioral change in addition to abdominal circumference and weight loss will result in self-care amongst the target population was largely endorsed. There were mixed opinions regarding the evaluation of behavioral change as an outcome of the specified health guidance. It is necessary to conduct further deliberation during the fourth planning period, through data accumulation. Moreover, in the context of specific health guidance, it is crucial to facilitate the “visualization” of information pertaining to the behavioral changes of the target group. This necessitates the establishment of a system that enables insurers to assess the status of achievement of outcomes and to examine the factors contributing to success. This will ensure the provision of high-quality health guidance to the target group. It is hoped that this revision will provide an opportunity for insurers to contribute to the development of specific health screening.