Analysis of the patient's behavior to select a hospital using gravity model : Five years transition in Hokkaido Prefecture, Japan

Autor: Ishizuka, Kazuya, Terashita, Takayoshi, Ohba, Hisateru, Tanikawa, Takumi, Ogasawara, Katsuhiko
Jazyk: japonština
Rok vydání: 2008
Předmět:
Zdroj: 日本医療・病院管理学会誌. 45(4):289-298
ISSN: 1882-594X
Popis: 研究資料
近年，市町村合併や高齢化などにより患者の受療動向も変化している可能性がある。我々はこれまで患者の受療動向を二次医療圏の病院数および二次医療圏間の距離を用いた重力モデルにより説明できることを報告した。今回，北海道の患者受療動向の変化の状況を明らかにするため，平成12年・平成17年の診療分国保患者受療動向調査結果を対象に分析を行った。医療資源の規模・集積によって吸引される影響度を示す規模依存係数β，患者の移動に対する抵抗の大きさを示す距離係数γを入院・外来別に算出し，二次医療圏ごとに散布図として表示した。更に対象期間における係数の変化量と方向をベクトルで表した。散布図より医療資源が不十分であり，移動に負担を感じる二次医療圏は主に道東地域（釧路，根室，十勝，北網，遠紋）であった。ベクトル図より，変化量の顕著な二次医療圏を抽出でき，特に上川北部は入院・外来両方で規模依存係数と距離係数が悪化傾向にあった。
The current trend observed in selecting a hospital by prospective patients may have been influenced by factors such as merging of municipalities and increasing number of senior citizens. Past studies have shown that such patient behavior can be explained by the gravity model by taking into account the number of hospitals in each secondary medical service area (SMSA) and the distance between the SMSAs. The purpose of this study is to understand the difference in this trend in patient behavior from 2000 to 2005 in Hokkaido Prefecture. The attraction parameter β, which represents the concentration of health resources in that area, and the distance parameter γ, which represents the distance between municipalities, were calculated for inpatients and outpatients based on the data provided by the National Health Insurance authorities in Hokkaido Prefecture. The β-γ graphs were plotted, and the Δβ-Δγ graphs (Vector graphs) were drawn to explain the time series of SMSAs. The patients had difficulty in selecting the hospitals in the SMSAs of Kushiro, Nemuro, Tokachi, Hokumo, and Enmon located in the eastern part of Hokkaido Prefecture because of a low concentration of healthcare resources and long distances. The vector graphs demonstrate the drastic change in these SMSAs from 2000 to 2005, and show that the Δβ and Δγ values for the Kamikawa-Hokubu SMSAs have a tendency to decline in case of inpatients as well as outpatients.
Databáze: OpenAIRE
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