| アブストラクト | AIM: Physician-led home-visit care has become essential in the super-aged society of Japan. To develop region-specific service systems, understanding regional differences in patient profiles is essential. This study aimed to describe regional differences in patient characteristics, service utilization, and outcomes, and to assess the associations between regional healthcare resources and patient outcomes. METHODS: This retrospective study used linked data from the National Database of Health Insurance Claims and Specific Health Checkups and the Japanese Long-term Care Database (April 2020-March 2021). Patients aged >/= 65 years receiving regular physician-led home visits in October 2020 were included. Analyses were conducted by prefecture and region. Associations between regional healthcare resources and patient outcomes were assessed using Spearman's correlation coefficients (rho). RESULTS: Among 337 863 patients, regional variations were observed. Western Japan had a higher prevalence of cancer, heart disease, respiratory disease, and orthopedic disorders, whereas Tohoku showed the highest rates of high care-need levels and home nursing utilization. Hospitalization risk was highest in western Japan, whereas in-home deaths were more frequent in eastern Japan. Hospital bed density was positively correlated with hospitalization risk (rho = 0.62) and negatively with 6-month mortality risk (rho = -0.44). Utilization of enhanced home care support clinics/hospitals was moderately associated with higher in-home death risks (rho = 0.49). CONCLUSIONS: Substantial regional differences exist in patient characteristics, service utilization, and outcomes among older adults receiving physician-led home-visit care. Healthcare resources were strongly associated with hospitalization and end-of-life care, highlighting the need for region-specific strategies to optimize healthcare delivery and resource allocation for the super-aged society of Japan. |
|---|
| 投稿者 | Sun, Yu; Komiyama, Jun; Iwagami, Masao; Sakata, Nobuo; Yoshie, Satoru; Ito, Tomoko; Sugiyama, Takahiro; Kashiwagi, Kimikazu; Tamiya, Nanako |
|---|
| 組織名 | Department of Health Services Research, Institute of Medicine, University of;Tsukuba, Ibaraki, Japan.;Health Services Research and Development Center, University of Tsukuba, Ibaraki,;Japan.;Department of Primary Care and Medical Education, Institute of Medicine,;University of Tsukuba, Ibaraki, Japan.;Heisei Medical Welfare Group Research Institute, Tokyo, Japan.;Department of Home Healthcare, Setagaya Memorial Hospital, Tokyo, Japan.;Institute of Gerontology, The University of Tokyo, Tokyo, Japan.;Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan.;Department of Health Policy and Management, School of Medicine, Keio University,;Tokyo, Japan.;School of Medicine, Hiroshima University, Hiroshima, Japan.;Diabetes and Metabolism Information Center, National Institute of Global Health;and Medicine, Japan Institute for Health Security, Tokyo, Japan.;Faculty of Nursing, National College of Nursing, Tokyo, Japan. |
|---|
