{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T21:06:52Z","timestamp":1789247212869,"version":"build-2803163510"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Foundation for Total Health Promotion, the Japan Agency for Medical Research and Development","award":["JP25ek0210219h0001"],"award-info":[{"award-number":["JP25ek0210219h0001"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Healthy life years are estimated from national population surveys that assess limitations in daily activities. However, the infrequent timing and limited sample sizes hinder the timely and detailed assessment of regional health conditions. We aimed to develop a novel method to estimate municipal-level healthy life years without activity limitations by using medical claims data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed medical claims data in Kyoto Prefecture, Japan. Outpatient data from May to July in 2016 and 2019 (n\u2009=\u20091\u2009489\u2009920) were used for development and data from the same period in 2022 (n\u2009=\u2009739\u2009236) were used for evaluation. A total of 5743 diagnostic codes were aggregated into 40 disease categories. A machine-learning model was employed to produce the probability of activity limitation, which was calibrated by using data from the Comprehensive Survey of Living Conditions and applied to derive age-specific prevalence rates. Healthy life years at the municipal level as of June 2022 were then estimated by incorporating a life table.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We observed variation in healthy life years among municipalities: 72.1\u2009years across all regions for males, ranging from 67.3 to 75.2\u2009years, and 75.8\u2009years for females, ranging from 71.3 to 77.6\u2009years. Regional disparities were also noted in the prevalence of diseases associated with activity limitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides the first robust, scalable method to estimate healthy life years without activity limitations at the municipal level by using real-world administrative data. Timely monitoring of regional healthy life years will support targeted health-promotion policies and contribute to reducing health disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ije\/dyag126","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:44:12Z","timestamp":1782859452000},"source":"Crossref","is-referenced-by-count":0,"title":["Estimating healthy life years without activity limitations using medical claims data in Japan"],"prefix":"10.1093","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8593-3835","authenticated-orcid":false,"given":"Masahiro","family":"Nishi","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reo","family":"Nagamitsu","sequence":"additional","affiliation":[{"name":"Department of Health and Welfare, Kyoto Prefectural Government , Kyoto,","place":["Japan"]},{"name":"Department of Epidemiology for Community Health and Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satomi","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Health and Welfare, Kyoto Prefectural Government , Kyoto,","place":["Japan"]},{"name":"Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoaki","family":"Matoba","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"2026091216221268800_dyag126-B1","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1093\/ije\/dyw126","article-title":"Smoking, physical inactivity and obesity as predictors of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study","volume":"45","author":"Stenholm","year":"2016","journal-title":"Int J Epidemiol"},{"key":"2026091216221268800_dyag126-B2","doi-asserted-by":"publisher","first-page":"2343","DOI":"10.1001\/jama.296.19.2343","article-title":"Midlife risk factors and healthy survival in men","volume":"296","author":"Willcox","year":"2006","journal-title":"Jama"},{"key":"2026091216221268800_dyag126-B3","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1016\/S0140-6736(12)61680-8","article-title":"Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010","volume":"380","author":"Salomon","year":"2012","journal-title":"Lancet"},{"key":"2026091216221268800_dyag126-B4","doi-asserted-by":"publisher","first-page":"e46634","DOI":"10.2196\/46634","article-title":"Development of a prediction model for healthy life years without activity limitation: national cross-sectional study","volume":"9","author":"Nishi","year":"2023","journal-title":"JMIR Public Health Surveill"},{"key":"2026091216221268800_dyag126-B5","doi-asserted-by":"publisher","first-page":"e101051","DOI":"10.1136\/bmjhci-2024-101051","article-title":"Association between daily step counts and healthy life years: a national cross-sectional study in Japan","volume":"31","author":"Nishi","year":"2024","journal-title":"BMJ Health Care Inform"},{"key":"2026091216221268800_dyag126-B6","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1007\/s12603-019-1219-5","article-title":"Traditional Japanese diet score - 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