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Table 3 Effect of co-insurance change in Japanese RA patients

From: Co-insurance and health care utilization in Japanese patients with rheumatoid arthritis: a discontinuity regression approach

Impact of co-payment change after turning 70 Intercept (95% CI) Monthly baseline trend before (95% CI) Level change immediately after (95% CI) Monthly trend change after (95% CI) Mean at age 69 Elasticity
1) Percentage of patients receiving bDMARDs among all RA patients
 Turned 70 before April 1st 2014 14.77 (14.04–15.51) − 0.09 (− 0.17 - -0.02) 3.13 (1.69–4.58) 0.01 (− 0.07–0.10) 13.44 − 0.35
 Turned 70 after April 1st 2014 11.53 (10.36–12.71) 0.05 (− 0.04–0.14) 0.50 (−1.13–2.11) − 0.10 (− 0.21–0.01) 12.59 − 0.12
2) Percentage of patients receiving bDMARDs among treated RA patients
 Turned 70 before April 1st 2014 47.13 (45.65–48.61) −0.16 (− 0.29 - -0.02) 7.43 (4.79–10.07) −0.08 (− 0.26–0.10) 44.71 −0.25
 Turned 70 after April 1st 2014 36.29 (34.95–37.63) 0.31 (0.19–0.42) −0.53 (−2.92–1.84) −0.27 (− 0.43 - -0.11) 42.17 0.04
3) Number of outpatient visits
 Turned 70 before April 1st 2014 1.73 (1.71–1.74) 0.002 (0.0008–0.004) 0.09 (0.05–0.13) −0.003 (− 0.005–0.0001) 1.78 −0.08
 Turned 70 after April 1st 2014 1.85 (1.83–1.88) − 0.005 (− 0.006 - -0.003) −0.03 (− 0.07 - -0.004) 0 (− 0.002–0.004) 1.80 0.05
4) Number of hospital admissions
 Turned 70 before April 1st 2014 0.07 (0.07–0.08) 0.001 (− 0.001–0.004) 0.003 (− 0.013–0.020) −0.005 (− 0.012–0.003) 0.07 −0.06
 Turned 70 after April 1st 2014 0.06 (0.05–0.07) 0.0006 (− 0.0002–0.001) −0.005 (− 0.013–0.003) 0 (− 0.002 – 0.0002) 0.08 0.19
5) Number of days in hospital     
 Turned 70 before April 1st 2014 0.82 (0.76–0.89) 0.002 (−0.002–0.007) −0.15 (− 0.27 - -0.02) 0.005 (− 0.005–0.016) 0.88 0.26
 Turned 70 after April 1st 2014 0.65 (0.49–0.81) 0.01 (0–0.02) −0.01 (− 0.22–0.19) −0.02 (− 0.03 - -0.003) 0.93 0.03
6) Number of re-hospitalizations
 Turned 70 before April 1st 2014 0.02 (0.01–0.02) - 0.0001 (−0.0003–0) 0.01 (0.004–0.017) 0.0004 (0.0001–0.0007) 0.02 −0.75
 Turned 70 after April 1st 2014 0.02 (0.01–0.02) 0 (−0.0002–0.0003) 0.001 (− 0.002–0.005) 0 (−0.001–0.00001) 0.02 −0.15
7) Number of ER visits
 Turned 70 before April 1st 2014 0.01 (0.01–0.01) 0 (−0.0002–0.0001) −0.002 (− 0.005–0.001) 0 (−0.001–0.004) 0.01 0.30
 Turned 70 after April 1st 2014 0.006 (0.003–0.008) 0 (0.0004–0.0004) −0.002 (− 0.006–0.002) 0 (−0.0003–0.0001) 0.01 0.60
8) Total cost JPY per person month*
 Turned 70 before April 1st 2014 96,219 (90,390 – 102,047) 404 (−47–857) 9939 (397–19,481) − 416 (− 1028–195) 107,196 −0.24
 Turned 70 after April 1st 2014 92,403 (88,335 – 96,471) 102 (− 246–450) − 3876 (− 11,099 – 3346) 458 (−151–1067) 95,423 0.12
9) OPD cost JPY per person month*
 Turned 70 before April 1st 2014 58,170 (56,644 – 59,696) 117 (−3–237) 5667 (2212 – 9122) −48 (− 252–155) 61,129 −0.08
 Turned 70 after April 1st 2014 49,882 (48,900 – 50,863) 188 (108–268) − 1033 (− 3341 – 1274) 84 (− 57–227) 53,715 0.06
10) IPD cost (actual) JPY per person month*
 Turned 70 before April 1st 2014 42,448 (38,932 – 45,963) −80 (− 376–215) 7534 (− 1904 – 16,972) 373 (− 287–1034) 46,067 −0.25
 Turned 70 after April 1st 2014 34,573 (28,538 – 40,608) 184 (− 267–636) −3014 (− 10,812 – 4783) − 812 (− 1418 - -206) 41,707 0.22
11) IPD cost (DPC) JPY per person month*
 Turned 70 before April 1st 2014 38,120 (30,575 – 45,665) 285 (−254–826) 4522 (− 6336 – 15,381) −387 (− 1092–316) 40,976 −0.17
 Turned 70 after April 1st 2014 32,903 (29,907 – 35,899) 159 (− 77–396) − 3032 (− 10,033 – 3968) 69 (− 516–654) 36,062 0.25
  1. bDMARDs biologic disease-modifying anti-rheumatic drugs, RA rheumatoid arthritis, CI confidence interval, DPC disease procedure combination, JPY Japanese yen, OPD out-patient department, IPD in-patient department, ER emergency room
  2. * All monetary values adjusted to 2016 values (Japan Consumer Price Index, 2017)
  3. Bold numbers indicate significance at 5% level