- Meeting abstract
- Open Access
- Published:
An analysis of the geographic distribution of acute-care hospitals and accessibility to care - based on the Japanese DPC database
BMC Health Services Research volume 9, Article number: A18 (2009)
Introduction
Geographic accessibility to care depends not only on the distribution of hospitals, but also on the services that each hospital provides. This study illustrates methods to utilize nationally collected hospital casemix information to analyze accessibility to care.
Methods
Hospital casemix data published by the Ministry of Health, Labor and Welfare (DPC [Diagnosis Procedure Combination] survey data) is used to construct a database of acute-care hospitals. Hospitals are then geo-coded, using their addresses, to calculate drive-times to a geographic mesh. The resulting hospital-to-mesh drive-time table is used to analyze accessibility to services in each region or prefecture.
Results
The 2007 DPC survey data consisted of 1,428 hospitals (16% of all hospitals), 457,000 beds (50% of all hospital beds), and four million discharges for the latter half of the year 2007. Coverage rates of population within 90 minutes of these hospitals were over 88.9% for all prefectures, with 33 out of 47 prefectures having rates over 99%. However, when the volume of services provided by each hospital was considered, population coverage showed a large disparity between prefectures and hospital services. The results also suggested the existence of a monopolistic provision of specific services in a few prefectures.
Conclusion
An analysis of the geographic accessibility to care relies deeply on a description of hospital services. Nationally collected information, such as the Japanese DPC survey data, is crucial in the pursuit of closing the care gap that exists in the real world.
Author information
Affiliations
Corresponding author
Correspondence to KB Ishikawa.
Rights and permissions
Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
About this article
Cite this article
Ishikawa, K., Matsuda, S. An analysis of the geographic distribution of acute-care hospitals and accessibility to care - based on the Japanese DPC database. BMC Health Serv Res 9, A18 (2009). https://doi.org/10.1186/1472-6963-9-S1-A18
Published:
Keywords
- Public Health
- Real World
- Survey Data
- Geographic Distribution
- Specific Service
