Association Between Specialist Distribution and Regional Variation in Plasmapheresis Use in Japan: A Population-Level...

Area of Science:

• Nephrology
• Healthcare Management
• Public Health

Background:

• Plasmapheresis is a common treatment in Japan, but its regional utilization patterns and links to specialist availability are not well understood.
• Understanding these factors is crucial for equitable healthcare access and resource allocation.

Purpose of the Study:

• To investigate the regional variations in plasmapheresis use across Japan.
• To examine the association between plasmapheresis utilization and the distribution of nephrologists, dialysis specialists, and apheresis specialists.

Main Methods:

• A cross-sectional study utilizing the 9th National Database Open Data (fiscal year 2022).
• Plasmapheresis use was identified via specific receipt codes.
• Age- and sex-adjusted standardized claim ratios (SCRs) were calculated, and multivariable-adjusted negative binomial regression models were employed.

Main Results:

• Plasmapheresis use varied 6.5-fold between regions, with SCRs ranging from 34.0 to 222.4.
• An increase in board-certified nephrologists (per 100,000 population) was significantly associated with higher plasmapheresis SCR (1.11-fold increase).
• No significant association was found between plasmapheresis use and the distribution of board-certified dialysis or apheresis specialists.

Conclusions:

• Significant regional disparities in plasmapheresis utilization exist in Japan.
• The distribution of nephrologists appears to be a key factor influencing plasmapheresis use, highlighting potential inequities in access.
• Further research into optimizing specialist distribution may improve treatment accessibility.