Non-Physician Areas in Japan: Typological Classification Based on Regional Demographic Characteristics.

Background: Across Japan, there are "non-physician areas" where medical institutions are not present and health care access is difficult. Although these areas are defined as a single administrative category, they may vary according to regional demographic characteristics. Understanding this possible heterogeneity may be important for developing more context-sensitive strategies to improve health care accessibility. Objective: This study examined whether non-physician areas can be classified based on regional demographic characteristics using an unsupervised machine learning model. Methods: A total of 590 non-physician areas were identified from the national survey conducted by the Ministry of Health, Labour and Welfare of Japan (2019). Data on regional demographic characteristics were also obtained. After Results: The optimal number of clusters was 3 (silhouette score=0.266), indicating that non-physician areas could be classified into 3 types. The cluster distributions of the training and validation datasets were consistent (Jensen-Shannon distance=0.017; Conclusions: The present study demonstrated that administratively defined non-physician areas in Japan are not uniform and can be classified into 3 demographically distinct types. The typology may provide a framework for understanding differences not captured by the current administrative designation and for considering more context-sensitive health care strategies.