Geographic variation in bronchoscopy use across Japan: A nationwide analysis using administrative claims data

Area of Science:

• Pulmonology
• Health Services Research
• Medical Procedure Analysis

Background:

• Bronchoscopy is a key diagnostic tool in respiratory medicine.
• Limited data exists on current bronchoscopy practices in Japan, despite an aging population.
• Understanding procedural patterns is crucial for healthcare planning.

Purpose of the Study:

• To analyze nationwide bronchoscopy procedural volumes and practice settings in Japan.
• To investigate regional variations in bronchoscopy utilization.
• To explore correlations between procedure volume, population aging, and specialist density.

Main Methods:

• Analysis of NDB Open Data for the 2023 fiscal year across all 47 Japanese prefectures.
• Calculation of nationwide and prefectural procedural rates per 100,000 population.
• Statistical analysis using Spearman's rank correlation to assess relationships between variables.

Main Results:

• A total of 177,317 bronchoscopies were performed nationwide (142.6 per 100,000 population).
• 78.8% of procedures were performed during inpatient care.
• Significant regional variations in procedural rates and inpatient proportions were observed.
• Procedure volume correlated positively with the density of board-certified respiratory specialists (ρ = 0.517, p < 0.001).
• No significant correlation was found between procedure volume and population aging rate.

Conclusions:

• Substantial regional disparities in bronchoscopy practices exist across Japan.
• The distribution of respiratory specialists appears to influence bronchoscopy procedure volume.
• Findings suggest specialist availability may impact patient access to this diagnostic procedure.