[in Japanese]

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Objectives An earlier study using the data from the Japanese Long-term Care Insurance (LTCI) system reported a scenario for achieving the target of Health Japan 21 (the second term): future gains in health expectancy from 2011 to 2020 must be larger than gains in expectancy. According to this scenario (the Healthy Life Expectancy Extension Scenario), the proportion of disability (cases≥Care Level 2 in LTCI disability certification) will gradually decrease by 1% per year from 2011. The purpose of this study was to estimate the cost savings in long-term care and medical care if the Healthy Life Expectancy Extension Scenario is achieved.
Methods We used data from Japanese national statistics and a survey conducted in Osaki city, Miyagi. The natural course of disability cases (≥Care Level 2) was estimated under the assumption that the future population composition would be equal to the population projections for Japan and the future proportion of disabilities for each age grade would be equal to that of 2010. Then, the decrease in the number of disabilities based on the Healthy Life Expectancy Extension Scenario was calculated. Finally, the cost savings in long-term care and medical care associated with the assumed decrease in the number of disability cases was calculated.
Results When the disability cases (≥Care Level 2) were shifted to “no disability certification (not requiring care),” a total estimated cost reduction of 5,291 billion yen was achieved from 2011 to 2020. Furthermore, a total estimated reduction of 2,491 billion yen was achieved for the same period when all disability shifts to “Care Level 1” were accounted for.
Conclusion As a rough calculation, if the Health Japan 21 (second term) target is achieved, approximately 2,500–5,300 billion yen will be saved in the cost of long-term care and medical care.

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Objectives The mean number of steps measured in the National Health and Nutrition Survey is employed for the assessment of physical activity/exercise in “Health Japan 21,” and is used to represent the amount of physical activity/exercise that citizens engage in. In this study, we clarified the characteristics of the data on the number of steps, drawn from the National Health and Nutrition Survey.
Methods Among the data from the National Health and Nutrition Surveys conducted from 2008 to 2010, data from 21,914 participants on daily number of steps and pedometer attachment were analyzed. On a nutritional intake questionnaire, subjects who responded on the physical status item that they had attached the pedometer all day long were assigned to the “Whole-day-attached” group. Their means, medians, outliers, and frequency distribution were then compared with those in a “Non- whole-day-attached” group.
Results Subjects assigned to the “Non- whole-day-attached” group accounted for about 8% of cases in 2008, 2009, and 2010. In all three years, the mean number of steps in the “Whole-day-attached” group was 1,076 to 1,472 higher than that in the “Non-whole-day-attached” group. In both groups, outliers were present, and the frequency distribution showed a broad range on the side indicating a higher number of steps. Accordingly, the mean value was higher than the median value by approximately 600 steps.
Conclusion As data on the number of steps measured in the National Health and Nutrition Survey includes individuals not attaching the pedometer all day (approximately 8% of cases), the data are not normally distributed. Therefore, when utilizing these data as representative of citizens’ physical activity/exercise, their characteristics should be taken into consideration.

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