A study on a reduction in visits to physicians after introduction of 30% co-payments in the employee health insurance in Japan

The purpose of the study is to evaluate influences of the introduction of 30% co-payments on potential visit behavior using a questionnaire in order to determine whether "employment state of the spouse" and "number of dependent children", as indicators of economic backgrounds, affect visits to physicians in a health insurance society. The subjects were 1,674 insured consisting of 1,165 males and 509 females, who underwent a regular health examination in July 2002, in a health insurance society. In the survey, they were asked whether the subject "will reduce" or "will not reduce" visits to physicians due to the increase in co-payments in the health insurance system scheduled in 2003. Multivariate analyses showed that "employment state of the spouse" was significantly related to the reduction in visits for myocardial infarction or stroke, cancer or heart disease, and hypertension and diabetes mellitus. Concerning "number of dependent children", it was related to the risk of reducing visits to physicians for myocardial infarction or stroke, trauma or fracture, cancer or heart disease, and low back pain or knee pain. Finally, upper limit expenditures of co-payments of physicians to visits due to hypertension and diabetes mellitus were related to "number of dependent children". The study results suggest that "employment state of the spouse" and "number of dependent children" are significant factors to affect potential visits to physicians after the introduction of 30% co-payments.