日本家庭医疗保健利用的区域差异:对全国索赔数据的生态研究
Masashi Shibata1,2, Makoto Kaneko3,4
1Department of General Medicine, Kaita Hospital, Fukuoka, Japan. mshibatah5@aih-net.com.
Journal of general internal medicine
|October 31, 2025
概括
在日本各地,家庭医疗保健的使用情况有很大差异,农村地区的医疗保健使用率较低. 日本农村经济指数 (RIJ) 有效地识别了这些医疗保健差异,指导了公平获取的政策.
科学领域:
- 老年学与公共卫生
- 获得医疗保健的机会和差距
- 农村卫生政策 农村卫生政策
背景情况:
- 由于人口快速老龄化和下降,日本面临着重大的人口挑战.
- 农村地区受到人口密度低,老年人口高,医疗接入有限等因素的不成比例影响.
- 家庭医疗保健是解决医疗保健能力和贫困地区公平问题的一个关键策略.
研究的目的:
- 量化日本各地家庭医疗保健利用率的区域差异.
- 调查家庭医疗保健使用与日本乡村指数 (RIJ) 之间的关联.
- 评估RIJ在识别医疗保健差异方面的实用性.
主要方法:
- 生态研究利用日本国家健康保险索赔数据库和2019-2020年特定健康检查 (NDB) 的开放数据.
- 分析包括335个二级医疗区 (SMA) 和47个县.
- 定期家庭访问,紧急家庭通话,死亡证明和终身护理的标准化索赔比率 (SCR) 与RIJ相关.
主要成果:
- 在家庭医疗利用方面发现了实质性的区域差异,最高/最低SCR比率从29.5到210.3.3不等.
- 较高的农村人口 (RIJ) 与定期家庭访问 (r=-0.619),紧急家庭呼叫 (r=-0.518) 和终身护理 (r=-0.541) 的使用率较低显著相关.
- 在RIJ和死亡证明之间观察到正相关性 (r=0.225),表明不同的使用模式.
结论:
- 在使用家庭医疗保健方面存在显著的区域差异,突出了地理障碍.
- 日本农村经济指数 (RIJ) 在识别服务利用率较低的地区方面被证明是有效的.
- 调查结果支持有针对性的政策干预措施,以改善日本农村家庭医疗保健的公平获取.
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