{"title":"日本接受医生家访护理的患者特征、服务利用和结果的地区差异：一项全国性研究。","authors":"Yu Sun, Jun Komiyama, Masao Iwagami, Nobuo Sakata, Satoru Yoshie, Tomoko Ito, Takahiro Sugiyama, Kimikazu Kashiwagi, Nanako Tamiya","doi":"10.1111/ggi.70202","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>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.</p><p><strong>Methods: </strong>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 (ρ).</p><p><strong>Results: </strong>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 (ρ = 0.62) and negatively with 6-month mortality risk (ρ = -0.44). Utilization of enhanced home care support clinics/hospitals was moderately associated with higher in-home death risks (ρ = 0.49).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Regional Differences in Characteristics, Service Utilization, and Outcome of Patients Receiving Physician-Led Home Visit Care in Japan: A Nationwide Study.\",\"authors\":\"Yu Sun, Jun Komiyama, Masao Iwagami, Nobuo Sakata, Satoru Yoshie, Tomoko Ito, Takahiro Sugiyama, Kimikazu Kashiwagi, Nanako Tamiya\",\"doi\":\"10.1111/ggi.70202\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>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.</p><p><strong>Methods: </strong>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 (ρ).</p><p><strong>Results: </strong>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 (ρ = 0.62) and negatively with 6-month mortality risk (ρ = -0.44). Utilization of enhanced home care support clinics/hospitals was moderately associated with higher in-home death risks (ρ = 0.49).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":12546,\"journal\":{\"name\":\"Geriatrics & Gerontology International\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-10-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Geriatrics & Gerontology International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/ggi.70202\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Geriatrics & Gerontology International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ggi.70202","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Regional Differences in Characteristics, Service Utilization, and Outcome of Patients Receiving Physician-Led Home Visit Care in Japan: A Nationwide Study.
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 (ρ).
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 (ρ = 0.62) and negatively with 6-month mortality risk (ρ = -0.44). Utilization of enhanced home care support clinics/hospitals was moderately associated with higher in-home death risks (ρ = 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.
期刊介绍：
Geriatrics & Gerontology International is the official Journal of the Japan Geriatrics Society, reflecting the growing importance of the subject area in developed economies and their particular significance to a country like Japan with a large aging population. Geriatrics & Gerontology International is now an international publication with contributions from around the world and published four times per year.
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