ArticlePloS one2017
Impact of geographic accessibility on utilization of the annual health check-ups by income level in Japan: A multilevel analysis.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Area-Level Determinants in Colorectal Cancer Spatial Clustering Studies: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Spatial accessibility and outpatient utilization among children aged 1-5 years in South Korea: a nationwide claims-based cross-sectional study, 2023.BMC health services research · 2026Article
- Article
- Students' perception of healthcare services and factors affecting their utilization at a Nigerian University: a cross-sectional study.Scientific reports · 2024Article
- The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use - results of a scoping review.International journal for equity in health · 2024Article
- Geographic variation in inpatient medical expenditure among older adults aged 75 years and above in Japan: a three-level multilevel analysis of nationwide data.Frontiers in public health · 2024Article
- The Health-Seeking Behavior among Malaysian Adults in Urban and Rural Areas Who Reported Sickness: Findings from the National Health and Morbidity Survey (NHMS) 2019.International journal of environmental research and public health · 2022Article
- Association of Participation in Health Check-ups with Risk Factors for Cardiovascular Diseases.Journal of Korean medical science · 2021Article
- Outpatient health service utilization and associated factors: A cross-sectional population-based study in Tehran in 2019.Medical journal of the Islamic Republic of Iran · 2021Article
- Determinants of Outpatient Health Service Utilization according to Andersen's Behavioral Model: A Systematic Scoping Review.Iranian journal of medical sciences · 2020Article
- Article
- Statistical factors associated with utilisation of ototoxicity monitoring services for multi-drug-resistant tuberculosis patients in the Western Cape.The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings · 2019Article
- Effect of geographic accessibility to primary care on treatment status of hypertension.PloS one · 2019Article
- Article
- Does the Distribution of Empanelled Hospitals have an Impact on the Utilization of Services under State Insurance Scheme?Indian journal of community medicine : official publication of Indian Association of Preventive & Social MedicineArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although both geographic accessibility and socioeconomic status have been indicated as being important factors for the utilization of health care services, their combined effect has not been evaluated. The aim of this study was to reveal whether an income-dependent difference in the impact of geographic accessibility on the utilization of government-led annual health check-ups exists. Existing data collected and provided by Chiba City Hall were employed and analyzed as a retrospective cohort study. The subjects were 166,966 beneficiaries of National Health Insurance in Chiba City, Japan, aged 40 to 74 years. Of all subjects, 54,748 (32.8%) had an annual health check-up in fiscal year 2012. As an optimal index of geographic accessibility has not been established, five measures were calculated: travel time to the nearest health care facility, density of health care facilities (number facilities within a 30-min walking distance from the district of residence), and three indices based on the two-step floating catchment area method. Three-level logistic regression modeling with random intercepts for household and district of residence was performed. Of the five measures, density of health care facilities was the most compatible according to Akaike's information criterion. Both low density and low income were associated with decreased utilization of the health check-ups. Furthermore, a linear relationship was observed between the density of facilities and utilization of the health check-ups in all income groups and its slope was significantly steeper among subjects with an equivalent income of 0.00 yen than among those with equivalent income of 1.01-2.00 million yen (p = 0.028) or 2.01 million yen or more (p = 0.040). This result indicated that subjects with lower incomes were more susceptible to the effects of geographic accessibility than were those with higher incomes. Thus, better geographic accessibility could increase the health check-up utilization and also decrease the income-related disparity of utilization.
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