糖尿病外来診療の医療機関の地理的分布─茨城県後期高齢者のケース  [in Japanese] Geographical distribution of primary care clinics for elderly ambulatory diabetic patients in Ibaraki Prefecture  [in Japanese]

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Abstract

<b>目的</b> : 高齢者が糖尿病の診療を受けるために通院する医療機関の地理的分布を検証する.<br><b>方法</b> : 茨城県で2010年5月の1ヶ月間に糖尿病を主病名として通院し後期高齢者医療制度により保険請求された診療データを用いて, 市町村ごとにその中心地から医療機関までの距離を測定し, これらの医療機関の地理的分布を検討した.<br><b>結果</b> : 対象は17,717件で, 住所地から地図上の位置情報に変換できた17,144件 (96.8%) を解析対象とした. 医療機関までの距離の中央値[四分位範囲]は5.5 [2.3-9.9]kmであった. これは, 性・年齢によってわずかに違いを認めるものの, 市町村の人口, 高齢化率, 市町村面積によって違いを認めなかった.<br><b>結論</b> : 高齢者が糖尿病で通院する医療機関は市町村中心から概ね10km範囲に分布していた. いくつかの限界はあるものの, 後期高齢者が増加する際の効率的医療資源の配置の資料になり得る.

<b>Introduction</b> : The appropriate size of the regional coverage area for primary care in Japan has been unclear. The aim of this study was to determine the geographical distribution of primary care clinics for elderly ambulatory diabetic patients.<br><b>Methods</b> : Using an insurance claims database, we extracted data of patients aged 75 years and older requiring ambulatory diabetic care in May 2010 in Ibaraki prefecture. The geographical distance from each municipal office to the clinics was analyzed.<br><b>Results</b> : A total of 17,717 data points were extracted from the database. Data points that could not be mapped due to coding errors were eliminated, resulting in 17,144 (96.8%) data points that were ultimately analyzed. The median [25th-75th percentile] geographical distance was 5.5 [2.3-9.9] km. The distance was not related to municipal population, aging rate, or area size.<br><b>Conclusion</b> : The coverage area for diabetic care in this primary care setting was estimated. For most elderly ambulatory diabetic patients, clinics are distributed within a 10-km radius area. Further investigation is needed to clarify primary care coverage areas that result in the most efficient use of medical resources.

Journal

  • An Official Journal of the Japan Primary Care Association

    An Official Journal of the Japan Primary Care Association 38(2), 127-130, 2015

    JAPAN PRIMARY CARE ASSOCIATION

Codes

  • NII Article ID (NAID)
    130005084261
  • NII NACSIS-CAT ID (NCID)
    AA12479442
  • Text Lang
    JPN
  • ISSN
    2185-2928
  • NDL Article ID
    026570097
  • NDL Call No.
    Z19-983
  • Data Source
    NDL  J-STAGE 
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