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      Effects of 2018 Japan floods on healthcare costs and service utilization in Japan: a retrospective cohort study

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          Abstract

          Background

          Floods and torrential rains are natural disasters caused by climate change. Unfortunately, such events are more frequent and are increasingly severe in recent times. The 2018 Japan Floods in western Japan were one of the largest such disasters. This study aimed to evaluate the effect of the 2018 Japan Floods on healthcare costs and service utilization.

          Methods

          This retrospective cohort study included all patients whose receipts accrued between July 2017 and June 2019 in Hiroshima, Okayama, and Ehime prefectures using the National Database of Health Insurance Claims. We used Generalized Estimating Equations (GEEs) to investigate yearly healthcare costs during the pre-and post-disaster periods, quarterly high-cost patients (top 10%), and service utilization (outpatient care, inpatient care, and dispensing pharmacy) during the post-disaster period. After the GEEs, we estimated the average marginal effects as the attributable disaster effect.

          Results

          The total number of participants was 5,534,276. Victims accounted for 0.65% of the total number of participants (n = 36,032). Although there was no significant difference in pre-disaster healthcare costs (p = 0.63), post-disaster costs were $3,382 (95% CI: 3,254–3,510) for victims and $3,027 (95% CI: 3,015–3,038) for non-victims (p < 0.001). The highest risk difference among high-cost patients was 0.8% (95% CI: 0.6–1.1) in the fourth quarter. In contrast, the highest risk difference of service utilization was in the first quarter (outpatient care: 7.0% (95% CI: 6.7–7.4), inpatient care: 1.3% (95% CI: 1.1–1.5), and dispensing pharmacy: 5.9% (95% CI: 5.5–6.4)).

          Conclusion

          Victims of the 2018 Japan Floods had higher medical costs and used more healthcare services than non-victims. In addition, the risk of higher medical costs was highest at the end of the observation period. It is necessary to estimate the increase in healthcare costs according to the disaster scale and plan for appropriate post-disaster healthcare service delivery.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12889-023-15205-w.

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          Most cited references22

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          Climate change and human health: present and future risks.

          Anthony J McMichael, Rosalie Woodruff, Simon Hales (2006)
          There is near unanimous scientific consensus that greenhouse gas emissions generated by human activity will change Earth's climate. The recent (globally averaged) warming by 0.5 degrees C is partly attributable to such anthropogenic emissions. Climate change will affect human health in many ways-mostly adversely. Here, we summarise the epidemiological evidence of how climate variations and trends affect various health outcomes. We assess the little evidence there is that recent global warming has already affected some health outcomes. We review the published estimates of future health effects of climate change over coming decades. Research so far has mostly focused on thermal stress, extreme weather events, and infectious diseases, with some attention to estimates of future regional food yields and hunger prevalence. An emerging broader approach addresses a wider spectrum of health risks due to the social, demographic, and economic disruptions of climate change. Evidence and anticipation of adverse health effects will strengthen the case for pre-emptive policies, and will also guide priorities for planned adaptive strategies.
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            Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission.

            Anthony Costello, Mustafa Abbas, Adriana Allen … (2009)
            Article 0 comments Cited 426 times – based on 0 reviews     Review now
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              Health effects of climate change: an overview of systematic reviews

              Rhea Rocque, Caroline Beaudoin, Ruth Ndjaboue … (2021)
              Objectives We aimed to develop a systematic synthesis of systematic reviews of health impacts of climate change, by synthesising studies’ characteristics, climate impacts, health outcomes and key findings. Design We conducted an overview of systematic reviews of health impacts of climate change. We registered our review in PROSPERO (CRD42019145972). No ethical approval was required since we used secondary data. Additional data are not available. Data sources On 22 June 2019, we searched Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane and Web of Science. Eligibility criteria We included systematic reviews that explored at least one health impact of climate change. Data extraction and synthesis We organised systematic reviews according to their key characteristics, including geographical regions, year of publication and authors’ affiliations. We mapped the climate effects and health outcomes being studied and synthesised major findings. We used a modified version of A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) to assess the quality of studies. Results We included 94 systematic reviews. Most were published after 2015 and approximately one-fifth contained meta-analyses. Reviews synthesised evidence about five categories of climate impacts; the two most common were meteorological and extreme weather events. Reviews covered 10 health outcome categories; the 3 most common were (1) infectious diseases, (2) mortality and (3) respiratory, cardiovascular or neurological outcomes. Most reviews suggested a deleterious impact of climate change on multiple adverse health outcomes, although the majority also called for more research. Conclusions Most systematic reviews suggest that climate change is associated with worse human health. This study provides a comprehensive higher order summary of research on health impacts of climate change. Study limitations include possible missed relevant reviews, no meta-meta-analyses, and no assessment of overlap. Future research could explore the potential explanations between these associations to propose adaptation and mitigation strategies and could include broader sociopsychological health impacts of climate change.
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                Author and article information

                Contributors
                Shuhei Yoshida: yoshida.shuhei.0810@gmail.com
                Journal
                Journal ID (nlm-ta): BMC Public Health
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2458
                Publication date (Electronic): 8 February 2023
                Publication date PMC-release: 8 February 2023
                Publication date Collection: 2023
                Volume: 23
                Electronic Location Identifier: 288
                Affiliations
                [1 ]GRID grid.257022.0, ISNI 0000 0000 8711 3200, Department of Community-Based Medical System, Graduate School of Biomedical and Health Sciences, , Hiroshima University, ; 1-2-3 Kasumi, Minami-ku, 734-8551 Hiroshima-shi, Hiroshima-ken, Japan
                [2 ]GRID grid.470097.d, ISNI 0000 0004 0618 7953, Department of General Internal Medicine, , Hiroshima University Hospital, ; 1-2-3 Kasumi, Minami-ku, 734-8551 Hiroshima-shi, Hiroshima-ken, Japan
                [3 ]GRID grid.257022.0, ISNI 0000 0000 8711 3200, Planetary Health and Innovation Science Center, IDEC Institute, , Hiroshima University, ; 1-3-2 Kagamiyama, Higashi-Hiroshima-shi, Hiroshima-ken, Japan
                [4 ]GRID grid.257022.0, ISNI 0000 0000 8711 3200, Environmental Health Sciences Laboratory, Graduate School of Advanced Science and Engineering, , Hiroshima University, ; 1-3-2 Kagamiyama, Higashi-Hiroshima-shi, Hiroshima-ken, Japan
                Article
                Publisher ID: 15205
                DOI: 10.1186/s12889-023-15205-w
                PMC ID: 9909853
                PubMed ID: 36755264
                SO-VID: 6b5d542b-3b22-41e6-98c2-4dd27243f984
                Copyright © © The Author(s) 2023
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 7 September 2022
                Date accepted : 3 February 2023
                Funding
                Funded by: Institute for Health Economics and Policy, Japan
                Award ID: NA
                Funded by: FundRef http://dx.doi.org/10.13039/501100001691, Japan Society for the Promotion of Science;
                Award ID: JP19K19388
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2023

                ScienceOpen disciplines: Public health
                Keywords: climate change,natural disaster,healthcare cost,healthcare service utilization
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: climate change, natural disaster, healthcare cost, healthcare service utilization

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