Analyzing the causes of the uneven geographical distribution of per-capita medical care expenditures for elderly persons aged 75 years or older between western and eastern Japanese prefectures
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- Kinoshita Naohiko
- Department of Health Informatics, Niigata University of Health and Welfare Graduate School of Health and Welfare, Niigata University of Health and Welfare
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- Hada Ryona
- Department of Health Informatics, Niigata University of Health and Welfare
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- Watanabe Senka
- Department of Health Informatics, Niigata University of Health and Welfare
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- Suzuki Akie
- Department of Health Informatics, Niigata University of Health and Welfare
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- Tajiri Masayuki
- Department of Health Informatics, Niigata University of Health and Welfare
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- Yamagishi Mina
- Department of Health Informatics, Niigata University of Health and Welfare
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- Kanno Suzuka
- Department of Health Informatics, Niigata University of Health and Welfare
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- Itagaki Takumi
- Department of Health Informatics, Niigata University of Health and Welfare
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- Namizuka Asuka
- Graduate School of Health and Welfare, Niigata University of Health and Welfare
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- Awashima Masahiro
- Department of Health Informatics, Niigata University of Health and Welfare
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- Kobayashi Fusayo
- Graduate School of Health and Welfare, Niigata University of Health and Welfare
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- Watarai Yuko
- Graduate School of Health and Welfare, Niigata University of Health and Welfare
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- Takigchi Toru
- Department of Health Informatics, Niigata University of Health and Welfare Graduate School of Health and Welfare, Niigata University of Health and Welfare
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説明
<p>The per-capita medical expenditures of elderly persons aged 75 years and older (hereafter, ME75) in each prefecture of western Japan and the Hokkaido area are higher than those in each of the eastern prefectures. This geographical uneven Distribution among ME75 in Japan can thus be summarized as follows: Per-capita medical expenditures among ME75 in Japan are higher in western areas than eastern areas (hereafter, WJhigh_EJlow). However, this uneven distribution has only been visually identified using a quartile map of ME75 without statistics. Further, current statistical verifications of the causes (e.g., supply and demand for medical care) are insufficient. As such, this study statistically confirmed uneven distribution among ME75 in different areas of Japan and identified the causes. Here, several specific analyses were conducted, including Fisher's exact test (hereafter, FET), bivariate Moran's I (hereafter, bi_MoI), and a quantitative analysis via multivariate regional clustering (hereafter, multi_RC) to adjust for confounding factors. All such analyses were performed using Bellcurve for Excel 3.20. Finally, a spacial_Multiple Regression Analysis (hereafter, spacial_MRA) of the GeoDa system was conducted to confirm uneven distribution, Results clearly showed a distribution of ME75 among all 47 Japanese prefectures following WJhigh_EJlow typed through multi_RC. Further, the population ratio of long-term care beds and general beds were identified as the main contributing economic medical factors via multi_RC with ME75 by spacial_MRA. The high ME75 in western Japan can be considered supporting evidence that elderly persons have high access to hospitals as required by the community-based integrated care system. On the other hand, low ME75 in eastern Japan will be evaluated because it will be considered to yield the collapse of the Japan's medical care system due to rapid rising of medical care expenditures. Therefore, further comparative studies will be necessary to determine whether the West Japan system is superior or the East Japan system is superior.</p>
収録刊行物
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- Niigata Journal of Health and Welfare
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Niigata Journal of Health and Welfare 20 (2), 61-72, 2020
新潟医療福祉学会
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詳細情報 詳細情報について
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- CRID
- 1390288004407009408
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- NII論文ID
- 130008037486
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- ISSN
- 24358088
- 13468782
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可