Healthcare administrators and hypertension at small-to-medium worksites in Okinawa, Japan

Abstract

This longitudinal study investigated whether the presence of a person in charge of healthcare at a worksite, termed a healthcare administrator (HA), and not limited to licensed staff, facilitated visits to medical facilities for treatment of newly-identified hypertension after a health checkup. The study included employees at small-to-medium companies in Okinawa, Japan who had systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, no history of hypertension in the last year, and not taking antihypertensive medication. Pre-existing data on worksite characteristics, employees' health checkups, and health insurance claims were collected. The odds ratio (OR) and 95% confidence interval (CI) were calculated for visits in the HA group using a multi-level logistic regression model, with the non-HA group serving as the reference. The cumulative incidence of visits during the 1^st month after the health checkup in 2906 participants with newly-identified hypertension employed at 1366 worksites was 2.00% for the non-HA group and 2.97% for the HA group. The OR for visits in the HA group was 1.74 (95% CI, 0.94-3.22) after adjusting for potential confounding factors. When the hypertensive population was stratified using the cut-off values of 150 mmHg for systolic and 95 mmHg for diastolic blood pressure, more hypertensive stratum showed a cumulative incidence of 2.29% in the non-HA group and 4.97% in the HA group, with an adjusted OR of 3.05 (1.12-8.29). The presence of a HA at a worksite was associated with increased early visits to medical facilities by employees for treatment of hypertension.

Keywords: Health checkups; Healthcare administrator; Hypertension; Visiting medical facilities; Worksite.