中小企業従業者のメンタルヘルスと企業特性:全国健康保険協会レセプトデータを用いた実証分析  [in Japanese] Mental Health of Small and Medium Enterprise Workers:An Empirical Analysis Using Medical Claims Data from Japan Health Insurance Association  [in Japanese]

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Abstract

<p>近年,日本の労働者における心の健康(メンタルヘルス)の問題が深刻化している。メンタルヘルス問題に関するこれまでの研究では,精神疾患の発症に至る蓋然性の高さを示す指標が用いられてきたものの,精神疾患の発症や受療の有無をアウトカムとした分析は乏しかった。そこで本研究では,中小企業労働者における精神疾患の受療行動と,個人や企業の特性との関係を明らかにする。具体的には,全国健康保険協会・兵庫支部の90万人の被保険者のレセプト(診療報酬明細書)データを使用し,記述統計ならびにロジット・モデルの推計により,「精神及び行動の障害」による受療率の差異を検証した。その結果,中小企業労働者の精神疾患の受療率は男性や働き盛り層で高く,代理指標を用いた従来の研究の知見とは部分的に異なる結果が得られた。また,都市部の受療率がそれ以外の地域より統計的に有意に高く,医療供給サイドの要因や生活要因の存在が示唆された。さらに,労働者の個人属性の影響を考慮してもなお,産業間の受療率の格差が大きく,特にホワイトカラー職種が中心の産業の受療率が高いことが確認された。このことは,メンタルヘルス問題の発生や対策を考える上で,産業構造や職務内容の変化,さらに人的資源管理などの要因を検証することの重要性を示唆している。</p>

<p>In the past two decades, we have been observing mental health problems of workers as a new type of social issues. Although previous studies have used various measures indicating high probability of mental health problem, relatively few studies have analyzed the incidence of or physician visits for mental disorder as an outcome measure.</p><p>In this study, we examine the incidence of mental health among small and medium enterprise(SME)workers, focusing on its relation to individual and firm characteristics. Specifically, we examine the differences in incidence rates of Mental and Behavioral Disorders among SME workers by both descriptive statistics and a logit model, using medical claims data from 900,000 enrollments of Japan Health Insurance Association Hyogo Branch.</p><p>The results show that among SME workers incidence rates of mental disorder are higher in males than females and highest for workers in their most productive years in working lives. This result is partly inconsistent with previous findings using proxy measures of mental health. Incidence rates are significantly higher in urban areas than rural areas, suggesting that regional differences in supply for medical services and/or a living environment affect the incidence of mental disorder. Furthermore, after controlling for individual characteristics, we find that there are large differences in the rates among industries; incidence rates of mental disorder are significantly high for industries which are largely occupied by white-collar workers. These results suggest that we should further investigate the change in industrial and occupational structures and the effect of human resource management in order to consider the incidence of and measures for the mental health problem among workers.</p>

Journal

  • Iryo To Shakai

    Iryo To Shakai 27(3), 377-391, 2017

    The Health Care Science Institute

Codes

  • NII Article ID (NAID)
    130006251888
  • NII NACSIS-CAT ID (NCID)
    AN10372213
  • Text Lang
    JPN
  • ISSN
    0916-9202
  • NDL Article ID
    028720026
  • NDL Call No.
    Z19-3523
  • Data Source
    NDL  J-STAGE 
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