Improvement measures in relation to the functional assessment of superior facilities are being implemented in Japan's general health checkup system for the further promotion of the safety and comfort levels among community residents. These measures include promoting the innovation of effective diagnostic techniques for early detection and treatment of lifestyle-related diseases and enhancing primary prevention for health promotion and healthcare support. Efforts are being made toward achievement of these objectives.
In the present study, by conducting a cluster analysis, we aimed to elucidate mutual relationships between functional assessment items related to the diagnostic ratio of “no abnormalities” among individuals undergoing general health checkups. We also aimed to obtain an overview of similarities among health checkup facilities by dividing Japan into seven regions. In order to achieve these objectives, we analyzed and published in our society's journal the nationwide results collected for facilities in fiscal year 2010.
The data were composed of complex confounding factors; therefore, it was analyzed using self-organizing maps (SOM).
No sex differences were observed in the ratios of facilities where a judgment of “no abnormalities” was made, but the following differences were found among the seven regions: similar relationships in functional assessment items related to regional characteristics were observed between “Kanto” and “Tokyo”, “Tokai/Koshinetsu” and “Chugoku/Shikoku”, and “Hokkaido/Tohoku” and “Kyushu/Okinawa”.
According to component map analysis of SOM, the ratio of individuals judged as having “no abnormalities” on health checkups was the highest in the “Kinki” region, somewhat high in “Tokai/Koshinetsu”, and the lowest in “Hokkaido/Tohoku”.
Functional assessment items that were closely related to the ratio of “no abnormalities” included the following: facilities having test equipment for helical computed tomography (CT), magnetic resonance imaging (MRI), and mammography; facilities with a large number of specialists; facilities with an independent floor for health checkups; facilities implementing smoking cessation measures; facilities at which physicians explain the results of health checkups; facilities conducting a small number of health checkups; facilities that provide lifestyle guidance and support or follow-up; facilities that do not have a large number of office personnel; facilities providing special health checkups and health guidance; facilities that do not conduct examinations more advanced than regular health checkups, such as Tokutei-Kenshin (Specific Health Examinations); and facilities at which the rate of instructions to undergo detailed examination in the general judgment was <30%.
The above findings suggest that conducting a large number of health checkups and having a large number of staff do not necessarily indicate a high level of quality, and reaffirm that assessment of the level of the contents of health checkup services at each facility is a more important issue. In other words, these findings indicate that health checkup facilities have internal issues they must actively address in order to improve each item in functional assessment.
View full abstract