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Analyzing Disparity in Geographical Accessibility to Home Medical Care Using a Claims Database and Geographical
Yasuhiro Morii1, Yasuhiro Nakanishi2, Yuichi Nishioka3
1Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako, Japan.
JMIR Aging
|August 6, 2025
Summary
Geographical accessibility to home medical care is poor in rural southern Nara, Japan. Improving resource allocation could significantly reduce travel times, especially in depopulated areas, enhancing access to essential health services.
Area of Science:
- Health Services Research
- Medical Geography
- Gerontology
Background:
- Aging societies face increasing demand for home medical care services.
- Optimal allocation of healthcare resources is crucial for meeting community needs.
- Geographical accessibility significantly impacts access to home medical care, yet regional disparities are under-researched.
Purpose of the Study:
- To analyze regional disparities in geographical accessibility to home medical care services in Nara Prefecture, Japan.
- To evaluate the impact of resource allocation on accessibility using a comprehensive medical claims database.
Main Methods:
- Utilized the Kokuho database (KDB) for medical claims data in Nara Prefecture.
- Employed a geographical information system (GIS) to analyze travel distance and time to home medical care services.
- Compared an ideal scenario (all providers) with an actual scenario (existing providers) for 39 municipalities.
Main Results:
- Rural southern municipalities exhibited travel distances exceeding 16 km and times over 30 minutes in the actual scenario.
- Depopulated southern areas like Totsukawa and Kawakami showed the most significant improvements in travel time in the ideal scenario.
- Lower home medical care usage rates were observed in southern rural municipalities.
Conclusions:
- Geographical accessibility to home medical care is notably lower in depopulated southern municipalities.
- Increasing healthcare resource supply in southern areas is necessary to address accessibility disparities.
- The KDB provides valuable data for geographical analysis reflecting actual healthcare usage patterns.
Keywords:
geographical accessibilitygeographical information systemhome medical caremedical claims databasesimulationMore Related Videos
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