Making time at a worksite increased medical visits by employees with hypertension at small-to-medium worksites in Okinawa, Japan

Abstract

This longitudinal study investigated whether a worksite healthcare policy of making time for medical visits (exposure factor) facilitated attendance (outcome) at these visits for treatment of newly identified hypertension after a health checkup. The study included employees at small-to-medium companies in Okinawa, Japan, who had a systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, no history of hypertension in the last year, and were not taking antihypertensive medication. Pre-existing data on worksite characteristics, employees’ health checkups, and health insurance claims were collected. A multilevel logistic regression model was used to calculate the odds ratio for the worksite group providing time to attend the medical visit, with the worksite group not providing this time acting as the reference. In the 2906 participants with newly identified hypertension employed at 1366 worksites, the cumulative incidence of interest increased gradually with longer follow-up in both groups, although the incidence was higher in the group providing time for the visit. After adjustment for potential confounding factors, the odds ratios (95% confidence interval) for visits by the end of the 4th, 5th, and 6th months after the health checkup in the group with time for a medical visit were 1.80 (1.13–2.86), 1.72 (1.10–2.70), and 1.55 (0.99–2.45), respectively. Similar patterns were observed for every stratum of company size, business category, and healthcare administrator status. These results indicate that a worksite making time for a visit to a medical facility was associated with increased visits by employees with newly identified hypertension at a health checkup.