Changes in the average interval since last visit and the number of repeat outpatients in the Patient Survey of Japan

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  • KUBO Shinichiro
    Nara Medical University Department of Public Heath, Health Management and Policy
  • NODA Tatsuya
    Nara Medical University Department of Public Heath, Health Management and Policy
  • KAWADO Miyuki
    Department of Hygiene, Fujita Health University School of Medicine
  • YAMADA Hiroya
    Department of Hygiene, Fujita Health University School of Medicine
  • NAKA MIENO Makiko
    Department of Medical Informatics, Center for Information, Jichi Medical University
  • TANIHARA Shinichi
    Teikyo University Graduate School of Public Health
  • MURAKAMI Yoshitaka
    Department of Medical Statistics, Toho University
  • HASHIMOTO Shuji
    Department of Hygiene, Fujita Health University School of Medicine
  • IMAMURA Tomoaki
    Nara Medical University Department of Public Heath, Health Management and Policy

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Other Title
  • 患者調査における平均診療間隔の分布と再来外来患者数推計値の変化
  • カンジャ チョウサ ニ オケル ヘイキン シンリョウ カンカク ノ ブンプ ト サイライ ガイライ カンジャスウ スイケイチ ノ ヘンカ

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<p>Objectives　The Patient Survey provides basic information on disease and injury statistics of patients in Japan, and an estimation of the number of patients by disease and injury can be made using this survey. In this survey, the number of outpatients with repeat visits affects the survey results. The average interval since last visit (AILV) and a correction factor are used to estimate the number of repeat outpatients. Patients with AILV > 30 days are not included in the survey. However, in the last years, AILV exceeded 30 days in many cases, suggesting that the current 30-day threshold is no longer suitable. Thus, this study investigated the AILV in the current patient population and the effect of the increase in AILV on the number of repeat outpatients.</p><p>Methods　Patients Survey data of 1996-2011 were used to estimate the effect of changing the AILV threshold on the number of repeat outpatients.</p><p>Results　AILV increased for patients with most diseases and injuries. Using the current 30-day threshold, the overall outpatient coverage rate decreased from 91% in 1996 to 78% in 2011. A higher AILV threshold was necessary to maintain the overall outpatient coverage rate. For example, a threshold of 90 days increased the coverage rate in 2011 to 96%. However, raising the threshold markedly increased the number of repeat outpatients. For example, the overall number of repeat outpatients in 2011 increased from 43.01 million with the current 30-day threshold to 71.03 million using the 90-day threshold. The peak of the AILV of outpatients was observed on the next day after the first visit and the peak of the AILV of outpatients was observed every other week.</p><p>Conclusion　AILV increased over time and changing the AILV threshold markedly increased the number of repeat outpatients and total patients, indicating that there is a need to raise the AILV threshold.</p>

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