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Impact of the 2016 Kumamoto Earthquake on ART Subsidy Applications in Kumamoto Prefecture: Interrupted Time-Series
Rumi Sasaki1,2, Takashi Ohba1,3, Miwa Nakamura1
1Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Aim:
Natural disasters may disrupt access to assisted reproductive technology (ART) services. This study evaluated the impact of the 2016 Kumamoto earthquake on ART utilization in Kumamoto Prefecture, accounting for nationwide trends and policy changes.
Methods:
We conducted an interrupted time-series analysis using annual ART subsidy application data in Kumamoto Prefecture from 2005 to 2020. Nationwide application counts were included as an offset to adjust for national trends related to the 2016 subsidy policy revision. Age-specific patterns were also examined using normalized indices.
Results:
In analysis adjusted for nationwide trends, ART subsidy applications showed a significant immediate reduction in 2016 (incidence rate ratio [IRR] = 0.84, 95% confidence interval [CI]: 0.77-0.91), followed by a gradual recovery (IRR for slope change = 1.06, 95% CI: 1.04-1.09). The decline was more pronounced among women aged 40 years and older, whereas applications among younger women remained relatively stable.
Conclusions:
The 2016 Kumamoto earthquake was associated with a substantial decline in ART subsidy applications in Kumamoto Prefecture beyond nationwide trends. This reduction was most pronounced among women aged 40 years and older, suggesting age-related differences in responses to disaster-related disruptions.
