特定保健指導の評価（2）：国保データによる準実験デザインを用いて

Objectives: The “Health Checkups and Healthcare Advice with Particular Focus on Metabolic Syndrome” (Tokutei Kenshin Hokenshido) started in 2008. We conducted a quasi-experimental study to elucidate the effects of healthcare advice. Methods: We used data from insured individuals who received health checkups in 2008 and 2009 under the National Health Insurance system, in all municipalities in Yamaguchi prefecture. We compared changes in the findings of health checkups in 2008 to 2009 between intervention subjects who received healthcare advice from 2008 and control subjects who did not receive advice. The control group was matched with the intervention group in terms of area, sex, age, and level of advice. Results: Data from 786 subjects in the intervention group and 1224 in the control group were analyzed. The following showed significant differences in the change in health checkup data between the intervention and control groups: body weight, −1.1 kg; BMI, −0.4 kg/m2; waist circumstance, −1.1 cm; triglyceride, −6.7 mg/dl; HDL-cholesterol, +1.0 mg/dl; LDL-cholesterol, −2.4 mg/dl; GPT, −1.4 IU/dl; γGTP, −2.4 IU/dl. There was no significant difference in blood pressure, FBS, or HbA1c. Conclusions: This quasi-experimental study demonstrated a moderate but significant effect of healthcare advice, although several items including blood pressure and blood glucose did not show significant improvement.