Evidence map›Paper›PMID 42220818›Full record

ArticleCureus2026

Direct and Functional Hazard Exposure of Urban Healthcare Systems Under Estimated Tsunami Inundation Zones: A Geographic Information System (GIS)-Based Cross-Boundary Analysis in Osaka City, Japan.

Kentaro Tanaka, Ryo Horiike, Itatani Tomoya, Hisao Nakai

Abstract read
In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kentaro TanakaNursing, Osaka Metropolitan University, Osaka, JPN.
Ryo HoriikeNursing, Nara Medical University, Nara, JPN.
Itatani TomoyaSchool of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN.
Hisao NakaiFaculty of Nursing, University of Kochi, Kochi, JPN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Tsunami disasters pose significant challenges to urban healthcare systems, particularly in densely populated coastal metropolitan areas. Although previous studies have examined hazard exposure and evacuation dynamics, limited attention has been paid to how healthcare system vulnerability arises from the combined effects of hazard exposure and population redistribution. This study examined the spatial relationships among estimated tsunami inundation zones, population distribution, and healthcare institutions in Osaka City, Japan, to identify structural vulnerabilities in urban healthcare systems. Methods A cross-sectional geographic information system (GIS)-based spatial analysis was conducted using publicly available secondary data from official sources, including the Hazard Map Portal Site (MLIT) and national census data (e-Stat). Spatial relationships among estimated tsunami inundation zones, population distribution, evacuation-related facilities, and medical institutions were examined. Spatial overlay analysis identified medical institutions located within inundation zones, and a nearest-neighbor approach was used to estimate changes in the population served by each institution under tsunami conditions. Results The analysis suggests a dual structure of healthcare system vulnerability. First, several healthcare institutions in Nishinari Ward were located within estimated tsunami inundation zones, indicating direct physical exposure and potential functional disruption. Second, medical institutions located outside inundation zones experienced substantial increases in the surrounding population under tsunami conditions, with some institutions showing up to a 5.5-fold increase compared to baseline levels. This reflects indirect functional exposure due to concentrated healthcare demand. Conclusion These findings suggest that disaster vulnerability in urban healthcare systems can be characterized by a dual structure consisting of direct physical exposure and indirect functional exposure. In large coastal metropolitan areas, effective disaster preparedness should consider not only static hazard exposure but also dynamic processes such as population redistribution and cross-boundary healthcare demand. Integrating these perspectives is important for developing more resilient healthcare planning strategies.

Indexed as

disaster preparednessgeographic information systemshealthcare systemmedical institutionstsunamivulnerability

Identifiers

PMID42220818
PMCPMC13222119

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.