背景:人口的减少可能会影响医疗保健服务和系统,特别是在人口减少的医疗服务不足地区(MUA)。这项研究旨在模拟日本MUA的未来人口和土地面积。
方法:这项研究涵盖了380,9481km网格,87,942个诊所,截至2020年,日本各地有8354家医院。医疗机构半径4公里以外的区域被认为是MUA,根据现行《日本医疗法》中的地区衡量标准。根据1公里网格的人口估计,使用地理信息系统分析,从2020年到2050年,每10年预测MUA的网格数量。如果距医疗机构4公里半径内的人口降至1000以下,则该机构在操作上被假定为关闭。
结果:MUA的数量预计将从2020年的964,310(占日本总人口的0.77%)减少到2050年的763,410(0.75%)。到2050年,预计有48,105个网格(占日本总网格的13%)是新的MUA,表明从2020年到2050年,MUA增加了31%。到2050年,初步估计有1601家医疗机构在附近。
结论:在日本,MUA的人口将会减少,而MUAs的土地面积将会增加。这些变化可能会改革农村医疗政策和制度。
BACKGROUND: A decrease in populations could affect healthcare access and systems, particularly in medically underserved areas (MUAs) where depopulation is becoming more prevalent. This study aimed to simulate the future population and land areas of MUAs in Japan.
METHODS: This study covered 380,948 1 km meshes, 87,942 clinics, and 8354 hospitals throughout Japan as of 2020. The areas outside a 4 km radius of medical institutions were considered as MUAs, based on the measure of areas in the current Japanese Medical Care Act. Based on the population estimate for a 1 km mesh, the population of mesh numbers of MUAs was predicted for every 10 years from 2020 to 2050 using geographic information system analysis. If the population within a 4 km radius from a medical institution fell below 1000, the institution was operationally assumed to be closed.
RESULTS: The number of MUAs was predicted to decrease from 964,310 (0.77% of the total Japanese population) in 2020 to 763,410 (0.75%) by 2050. By 2050, 48,105 meshes (13% of the total meshes in Japan) were predicted to be new MUAs, indicating a 31% increase in MUAs from 2020 to 2050. By 2050, 1601 medical institutions were tentatively estimated to be in close proximity.
CONCLUSIONS: In Japan, the population of MUAs will decrease, while the land area of MUAs will increase. Such changes may reform rural healthcare policy and systems.