| Total (n = 838) | Dedicated to check-ups/Annexed to clinics (n = 320) | Annexed to hospitals (n = 518) | P value | ||
|---|---|---|---|---|---|
| Areaa | Kanto | 301 (35.9) | 132 (41.3) | 169 (32.6) | 0.035 |
| Hokkaido | 21 (2.5) | 11 (3.4) | 10 (1.9) | ||
| Tohoku | 44 (5.3) | 14 (4.4) | 30 (5.8) | ||
| Chubu | 157 (18.7) | 45 (14.1) | 112 (21.6) | ||
| Kansai | 148 (17.7) | 63 (19.7) | 85 (16.4) | ||
| Chugoku | 60 (7.2) | 22 (6.9) | 38 (7.3) | ||
| Shikoku | 23 (2.7) | 7 (2.2) | 16 (3.1) | ||
| Kyushu | 73 (8.7) | 22 (6.9) | 51 (9.8) | ||
| Okinawa | 11 (1.3) | 4 (1.3) | 7 (1.4) | ||
| Location of facilities | Ordinance-designated cities/special wards in Tokyo | 310 (37.0) | 172 (53.8) | 138 (26.6) | <0.001 |
| Public or private institutions | Public | 190 (22.7) | 17 (5.3) | 173 (33.4) | <0.001 |
| Number of employees | 1-10 | 140 (16.7) | 39 (12.2) | 101 (19.5) | <0.001 |
| 11-20 | 237 (28.3) | 52 (16.3) | 185 (35.7) | ||
| 21-30 | 163 (19.5) | 54 (16.9) | 109 (21.0) | ||
| 31-40 | 86 (10.3) | 36 (11.3) | 50 (9.7) | ||
| 41-50 | 66 (7.9) | 38 (11.9) | 28 (5.4) | ||
| >50 | 146 (17.4) | 101 (31.6) | 45 (8.7) | ||
| Accepting admission of patients with COVID-19 | Yes | 419 (50.0) | 11 (3.4) | 408 (78.8) | <0.001 |
| Outpatient fever clinic | Yes | 518 (61.8) | 64 (20.0) | 454 (87.6) | <0.001 |
| Providing COVID-19 vaccination services | Yes | 650 (77.6) | 183 (57.2) | 467 (90.2) | <0.001 |
| COVID-19 PCR center | Yes | 149 (17.8) | 18 (5.6) | 131 (25.3) | <0.001 |
| Providing help to other departments within the facility | Yes | 482 (57.5) | 139 (43.4) | 343 (66.2) | <0.001 |
| Providing help to other departments for COVID-19-related care | Yes | 359 (42.8) | 90 (28.1) | 269 (51.9) | <0.001 |
| Negative financial impact in 2020 | Yes | 675 (80.5) | 253 (79.1) | 422 (81.5) | 0.346 |
| Negative financial impact in 2021 | Yes | 612 (73.0) | 224 (70.0) | 388 (74.9) | 0.098 |
| Negative financial impact in 2022 | Yes | 517 (61.7) | 176 (55.0) | 341 (65.8) | 0.001 |
| Number of facilitiesb | (n = 492) | (n = 185) | (n = 307) | ||
| Total number of check-ups in 2019 | Median (IQR) | 14007 (6600, 32037) | 28518 (14645, 74869) | 9833 (5113, 18466) | <0.001 |
| <10000 | 188 (38.2) | 33 (17.8) | 155 (50.5) | <0.001 | |
| 10000-19999 | 115 (23.4) | 30 (16.2) | 85 (27.7) | ||
| 20000-39999 | 91 (18.5) | 53 (28.6) | 38 (12.4) | ||
| ≥40000 | 98 (19.9) | 69 (37.3) | 29 (9.4) | ||
| Percentage of mandatory check-upsc in 2019 | Median (IQR) | 34.0 (18.0, 54.6) | 31.6 (15.4, 60.0) | 34.7 (19.0, 50.5) | 0.622 |
| <34% | 246 (50.0) | 96 (51.9) | 150 (48.9) | 0.577 | |
| ≥34% | 246 (50.0) | 89 (48.1) | 157 (51.1) | ||
| Percent change in the number of check-ups in 2022 compared with 2019 | Median (IQR) | −1.5 (−7.4, 6.0) | 0.1 (−5.8, 9.1) | −2.5 (−8.9, 4.7) | 0.001 |
| Mandatorya | 2020 median (IQR) | P valueb | 2021 median (IQR) | P valueb | 2022 median (IQR) | P valueb | Number of facilitiesc | |
|---|---|---|---|---|---|---|---|---|
| All check-ups | - | −9.0 (−15.2, −4.0) | <0.001 | −0.7 (−6.4, +4.5) | 0.087 | −1.5 (−7.4, +6.0) | 0.022 | 492 |
| Check-ups based on Industrial Safety and Health Act | Yes | −4.7 (−11.3, +1.5) | <0.001 | +2.3 (−5.8, +10.8) | <0.001 | +3.5 (−6.4, +16.1) | <0.001 | 441 |
| Check-ups for prevention of lifestyle-related diseases | Yes | −5.3 (−13.1, +0.8) | <0.001 | +4.9 (−2.3, +11.9) | <0.001 | +5.3 (−3.6, +15.2) | <0.001 | 442 |
| Comprehensive check-ups (Ningen Dock)d | Yes/No | −9.3 (−15.6, −3.6) | <0.001 | −0.2 (−6.5, +6.3) | >0.99 | −0.7 (−7.1, +9.0) | >0.99 | 479 |
| Specific Health Check-ups alonee | No | −14.5 (−26.3, −4.5) | <0.001 | −4.6 (−16.0, +9.2) | <0.001 | −4.1 (−18.0, +12.6) | 0.015 | 412 |
| Cancer screenings by local governments | No | −13.1 (−24.3, −1.0) | <0.001 | −3.1 (−16.0, +12.6) | 0.009 | −4.1 (−20.3, +20.3) | 0.019 | 341 |
| Other in-facility check-upsf | No | −10.9 (−22.8, +0.8) | <0.001 | −3.6 (−18.2, +11.0) | 0.002 | −6.4 (−19.5, +12.2) | <0.001 | 455 |
| Check-ups using mobile medical vehicles | Yes/No | −11.3 (−19.6, −5.2) | <0.001 | −5.6 (−14.5, +0.3) | <0.001 | −8.2 (−18.1, −1.1) | <0.001 | 156 |
| Rate % in 2019, median (IQR) | Rate % in 2020, median (IQR) | Difference % (2020−2019), median (IQR) | P valuea | Rate % in 2021, median (IQR) | Difference % (2021−2019), median (IQR) | P valuea | Number of facilities | |
|---|---|---|---|---|---|---|---|---|
| Gastric cancer (contrast radiography) | 4.1 (2.1, 7.3) | 3.4 (1.7, 6.4) | −0.34 (−1.34, 0.18) | <0.001 | 3.1 (1.7, 5.9) | −0.60 (−1.92, 0.08) | <0.001 | 356 |
| Gastric cancer (endoscopy) | 3.7 (1.8, 6.6) | 3.5 (1.6, 6.0) | −0.23 (−0.95, 0.20) | <0.001 | 3.5 (1.8, 6.0) | −0.18 (−1.17, 0.56) | 0.003 | 342 |
| Colorectal cancer | 5.5 (4.7, 6.4) | 5.6 (4.8, 6.5) | +0.12 (−0.31, 0.54) | <0.001 | 5.4 (4.5, 6.1) | −0.13 (−0.54, 0.25) | <0.001 | 365 |
| Lung cancer | 1.5 (0.9, 2.4) | 1.4 (0.8, 2.3) | −0.09 (−0.40, 0.15) | <0.001 | 1.3 (0.7, 2.2) | −0.14 (−0.52, 0.14) | <0.001 | 365 |
| Breast cancer (mammography) | 5.1 (3.1, 7.6) | 5.0 (3.0, 7.4) | −0.11 (−1.24, 0.69) | 0.238 | 4.8 (3.0, 7.0) | −0.29 (−1.61, 0.88) | 0.028 | 362 |
| Breast cancer (ultrasound) | 3.1 (1.9, 5.2) | 3.0 (1.7, 4.7) | −0.17 (−1.04, 0.59) | 0.016 | 2.7 (1.6, 4.5) | −0.22 (−1.39, 0.57) | <0.001 | 309 |
| Cervical cancer | 1.9 (1.0, 3.4) | 1.9 (1.1, 3.4) | +0.03 (−0.47, 0.50) | >0.99 | 2.0 (1.1, 3.6) | +0.02 (−0.62, 0.74) | >0.99 | 361 |
| Hypertension | 1.7 (0.7, 2.8) | 1.9 (0.7, 3.1) | +0.10 (−0.04, 0.49) | <0.001 | 1.8 (0.7, 2.9) | +0.07 (−0.15, 0.39) | <0.001 | 353 |
| Diabetes | 1.5 (0.8, 2.8) | 1.6 (0.8, 2.8) | 0.00 (−0.15, 0.17) | 0.226 | 1.4 (0.8, 2.6) | −0.02 (−0.31, 0.18) | 0.134 | 354 |
| Dyslipidemia | 4.5 (2.3, 6.6) | 4.5 (2.5, 7.1) | +0.04 (−0.29, 0.48) | 0.044 | 4.6 (2.6, 6.9) | 0.00 (−0.46, 0.65) | 0.477 | 352 |
| Rate % in 2019, median (IQR) | Rate % in 2020, median (IQR) | Difference % (2020−2019), median (IQR) | P valuea | Rate % in 2021, median (IQR) | Difference % (2021−2019), median (IQR) | P valuea | Number of facilities | |
|---|---|---|---|---|---|---|---|---|
| Gastric cancer (contrast radiography) | 53.2 (39.5, 65.5) | 54.9 (40.3, 66.7) | −0.2 (−5.6, 4.7) | 0.669 | 56.5 (40.0, 68.5) | +0.7 (−5.8, 9.9) | 0.248 | 300 |
| Gastric cancer (endoscopy) | 84.9 (63.8, 97.8) | 84.6 (64.2, 98.0) | 0.0 (−4.2, 2.9) | 0.906 | 86.8 (64.7, 98.5) | 0.0 (−4.1, 3.8) | 0.939 | 295 |
| Colorectal cancer | 51.8 (39.9, 63.6) | 52.8 (41.3, 62.8) | +0.2 (−4, 4.1) | 0.648 | 53.2 (41.7, 64.6) | 0.0 (−4.3, 5.0) | 0.648 | 316 |
| Lung cancer | 66.3 (49.2, 80.4) | 66.7 (51.2, 79.3) | +1.0 (−4.7, 6.6) | 0.068 | 69.1 (53.5, 80.0) | +1.3 (−5.0, 8.0) | 0.032 | 321 |
| Breast cancer (mammography) | 80.5 (60.1, 89.5) | 81.3 (63.6, 89.0) | 0.0 (−4.9, 6.2) | 0.753 | 81.1 (64.5, 89.5) | 0.0 (−6.1, 6.7) | >0.99 | 313 |
| Breast cancer (ultrasound) | 76.1 (55.7, 89.4) | 79.7 (60.0, 90.7) | +0.2 (−5.6, 9.3) | 0.096 | 80.2 (58.9, 91.3) | +1.4 (−4.8, 11.4) | 0.014 | 248 |
| Cervical cancer | 71.6 (53.0, 83.7) | 75.0 (56.9, 86.4) | +1.3 (−4.8, 9.9) | 0.005 | 76.9 (58.1, 89.1) | +1.8 (−3.7, 11.7) | <0.001 | 299 |
| Hypertension | 30.5 (14.1, 43.9) | 34.5 (17.2, 48.7) | +0.8 (−1.6, 7.5) | <0.001 | 37.1 (19.7, 52.4) | +1.8 (−2.3, 10.0) | <0.001 | 258 |
| Diabetes | 37.2 (19.2, 54.5) | 39.6 (20.2, 56.1) | +1.1 (−2.5, 7.3) | 0.002 | 40.3 (20.5, 59.9) | +1.7 (−1.9, 8.8) | <0.001 | 274 |
| Dyslipidemia | 29.6 (15.7, 43.5) | 31.1 (15.7, 43.5) | +0.1 (−3.5, 3.1) | 0.566 | 31.7 (16.7, 45.8) | +1.2 (−2.7, 6.5) | 0.013 | 271 |
| Univariate | Multivariate Model 1 a | Multivariate Model 2 b | |||||
|---|---|---|---|---|---|---|---|
| Odds ratio (95% CI) | P value | Odds ratio (95% CI) | P value | Odds ratio (95% CI) | P value | ||
| (Intercept) | - | 0.87 (0.47, 1.59) | 0.645 | 1.19 (0.43, 3.28) | 0.743 | ||
| Type of facility | Dedicated to healthcare check-ups/annexed to clinics |
Ref | Ref | Ref | |||
| Annexed to hospitals | 1.66 (1.23, 2.24) | <0.001 | 3.57 (2.03, 6.27) | <0.001 | 4.02 (1.77, 9.13) | <0.001 | |
| Area | Kanto | Ref | Ref | Ref | |||
| Hokkaido | 0.51 (0.21, 1.28) | 0.151 | 0.47 (0.18, 1.22) | 0.122 | 0.37 (0.09, 1.62) | 0.189 | |
| Tohoku | 1.77 (0.81, 3.86) | 0.153 | 1.89 (0.85, 4.23) | 0.120 | 1.62 (0.53, 4.98) | 0.398 | |
| Chubu | 1.31 (0.85, 2.03) | 0.219 | 1.25 (0.79, 1.99) | 0.334 | 1.41 (0.69, 2.86) | 0.343 | |
| Kansai | 0.72 (0.47, 1.09) | 0.117 | 0.77 (0.50, 1.19) | 0.235 | 0.75 (0.40, 1.39) | 0.358 | |
| Chugoku | 1.08 (0.59, 1.97) | 0.800 | 1.09 (0.59, 2.04) | 0.778 | 1.07 (0.45, 2.51) | 0.881 | |
| Shikoku | 0.42 (0.17, 1.05) | 0.063 | 0.44 (0.17, 1.16) | 0.098 | 0.61 (0.17, 2.12) | 0.434 | |
| Kyushu | 0.85 (0.49, 1.46) | 0.555 | 0.88 (0.50, 1.56) | 0.671 | 0.88 (0.37, 2.10) | 0.774 | |
| Okinawa | 2.31 (0.49, 10.9) | 0.290 | 2.59 (0.52, 12.97) | 0.247 | 4.27 (0.47, 38.58) | 0.196 | |
| Location of facilities | Ordinance-designated cities or special wards in Tokyo vs. others |
1.29 (0.95, 1.76) | 0.102 | 1.52 (1.07, 2.15) | 0.020 | 1.40 (0.85, 2.32) | 0.187 |
| Public or private | Public | 1.56 (1.08, 2.26) | 0.019 | 1.42 (0.93, 2.17) | 0.105 | 1.02 (0.56, 1.87) | 0.944 |
| Number of employees | 1-10 | Ref | Ref | Ref | |||
| 11-50 | 1.91 (1.29, 2.83) | 0.001 | 1.73 (1.13, 2.64) | 0.011 | 2.20 (1.03, 4.67) | 0.041 | |
| >50 | 2.01 (1.22, 3.30) | 0.006 | 2.05 (1.17, 3.61) | 0.012 | 2.65 (0.99, 7.09) | 0.053 | |
| Accepting admission of patients with COVID-19 | Yes vs. no | 1.19 (0.89, 1.60) | 0.238 | 0.59 (0.35, 0.98) | 0.042 | 0.86 (0.42, 1.76) | 0.671 |
| Outpatient fever clinic | Yes vs. no | 1.07 (0.79, 1.45) | 0.646 | 0.88 (0.55, 1.41) | 0.591 | 0.71 (0.35, 1.41) | 0.327 |
| Providing COVID-19 vaccination services | Yes vs. no | 0.76 (0.53, 1.10) | 0.142 | 0.65 (0.42, 1.00) | 0.051 | 0.51 (0.27, 0.96) | 0.037 |
| COVID-19 PCR center | Yes vs. no | 0.80 (0.55, 1.17) | 0.249 | 0.75 (0.50, 1.13) | 0.169 | 1.10 (0.58, 2.06) | 0.777 |
| Providing help to other departments | Yes vs. no | 1.22 (0.91, 1.64) | 0.192 | 1.13 (0.81, 1.57) | 0.474 | 1.07 (0.67, 1.73) | 0.767 |
| Total number of check-ups in 2019 | <10000 | Ref | Ref | ||||
| 10000-19999 | 1.31 (0.78, 2.19) | 0.310 | 0.94 (0.50, 1.75) | 0.839 | |||
| 20000-39999 | 1.42 (0.80, 2.54) | 0.233 | 1.36 (0.65, 2.85) | 0.418 | |||
| ≥40000 | 1.50 (0.84, 2.67) | 0.170 | 1.25 (0.52, 3.02) | 0.612 | |||
| Proportion of mandatory check-upsc in 2019 | <34% | Ref | Ref | ||||
| ≥34% | 0.58 (0.38, 0.89) | 0.013 | 0.55 (0.34, 0.90) | 0.016 | |||
