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Regional Variations in Coronavirus Disease 2019 Mortality in Japan: An Ecological Study
Akihisa Nakamura1, Kazuhiko Kotani1, Shuji Hatakeyama2,3
1Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan.
JMA Journal
|November 9, 2023
Summary
Regional characteristics impact COVID-19 mortality. More physicians per hospital bed and fewer long-term care facilities correlate with lower coronavirus disease 2019 (COVID-19) deaths, especially in less populated areas.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Coronavirus disease 2019 (COVID-19) outcomes vary geographically.
- Regional factors like healthcare resource distribution may influence COVID-19 mortality rates.
Purpose of the Study:
- To investigate the relationship between regional characteristics and COVID-19 mortality in Japan.
- To assess how physician and hospital bed distribution affects COVID-19 mortality across prefectures.
Main Methods:
- Ecological study during Japan's seventh COVID-19 wave (June-October 2022).
- COVID-19 mortality index calculated as deaths per new cases.
- Correlations analyzed between regional factors (population, physicians, hospital beds, long-term care facilities, aging rate) and mortality index, stratified by population size.
Main Results:
- COVID-19 mortality negatively correlated with physicians per hospital bed (r = -0.386, p = 0.007).
- Mortality positively correlated with long-term care facilities (r = 0.397, p = 0.006) and aging rate (r = 0.471, p = 0.001).
- In less populated areas, mortality was lower with more physicians per hospital bed (β = -0.543, p = 0.024) and higher with increased aging rate (β = 0.434, p = 0.032).
Conclusions:
- Healthcare resource distribution, particularly physicians and hospital beds, is linked to COVID-19 mortality.
- Targeted improvements in healthcare systems for smaller, older populations may reduce COVID-19 mortality.
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