ArticleJournal of general internal medicine2026
Regional Disparities in Home-Based Medical Care Utilization in Japan: Ecological Study of Nationwide Claim Data.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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Who cites it
5 citing papers in PubMed.
- Geographic variation and factors associated with home-based long-term care utilization across municipalities in Japan.BMC global and public health · 2026Article
- Shared Decision Making as a Policy and Clinical Framework for the Responsible Introduction of Repetitive Transcranial Magnetic Stimulation Therapy in Japan.Psychiatry investigation · 2026Article
- Testing and evaluating updated variants of the rurality index for Japan: a nationwide methodological study.BMJ open · 2026Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundJapan faces demographic challenges with rapid population aging and decline, especially in rural areas with low population density, high proportions of older adults, and limited medical accessibility. Home-based medical care has emerged as a potential solution to expand healthcare capacity and reduce health disparities in these areas.
objectiveTo quantify regional variations in home-based medical care utilization and to examine their association with Rurality Index for Japan (RIJ), a composite measure incorporating population density, geographical distance, and climatic factors.
designEcological study using open data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) for 2019-2020.
participantsIn total, 335 secondary medical areas (SMAs) and 47 prefectures across Japan. MAIN MEASURES: Standardized Claim Ratio (SCR) for four indicators of home-based medical care: regular home visits, emergency house calls, death certificates, and end-of-life care; and their correlation with RIJ. KEY
resultsSignificant regional disparities were observed with maximum/minimum ratios of 82.0, 210.3, 33.2, and 29.5 for regular home visits, emergency house calls, death certificates, and end-of-life care, respectively. Spearman's rank correlation coefficients between SCR and RIJ were -0.619 for regular home visits, -0.518 for emergency house calls, 0.225 for death certificates, and -0.541 for end-of-life care (all P < 0.001).
conclusionsSeveral dozen-fold regional disparities exist in home-based medical care utilization across Japan, with higher rurality associated with lower utilization of most services. These findings suggest geographical barriers significantly influence access to home-based medical care. Our findings highlight the utility of RIJ as an effective measure to identify and address these healthcare disparities, informing targeted policy interventions to improve equitable access to home-based medical care in rural Japan.
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