Quantitative Evaluation of Difficulty in Visiting Hospitals for Elderly Patients in Depopulated Area in Japan: Using National Health Insurance Data

Abstract

Depopulation is occurring in rural areas of Japan due to the outflow of the population to urban areas, the declining birthrate, and the aging population. Within depopulated areas, there is a problem of declining accessibility to medical facilities due to the decline of the medical system and transportation infrastructure. Therefore, measuring accessibility to medical facilities in underpopulated areas is an important issue. In this study, we calculated an accessibility index (APMI) to medical facilities in underpopulated areas in Japan using geographical information such as elevation, distance to medical facilities, and distance to bus stops. Furthermore, we estimated the number of patients who are considered to have difficulty visiting hospitals by using the National Health Insurance data (KDB) owned by all local governments in Japan. Through the analysis in this study, it became clear that accessibility was extremely low in the mountainous area of Hakui, Ishikawa Prefecture, and the number of patients living there could be determined. In addition, priority areas for improving the environment for visiting the hospital were identified.