Hashimoto S, Nakamura Y, Nagai M, Fujita Y, Yanagawa H, Hashimoto T, Nakamura K
Department of Demography and Health Statistics, Institute of Public Health, Tokyo.
Nihon Eiseigaku Zasshi. 1992 Oct;47(4):831-42. doi: 10.1265/jjh.47.831.
In order to determine the characteristics of medical institutions which patients with 30 intractable diseases visited, we analyzed data of a nationwide survey conducted by the Epidemiology of Intractable Diseases Research Committee in 1989. Each of 47 prefectural governments in Japan reported information of all patients with 30 intractable diseases who received financial aid for the diseases between April 1988 and March 1989. Information collected about each patient consisted of identification numbers, which included the disease code, sex, age, the code of the municipality where the patient lived, the medical institution which treated the patient, etc. Out of 173,637 patients whose information was reported by prefectural governments, we used data of 159,910 patients whose medical institutions were reported completely. The results can be summarized as follow: 1) Of the 159,910 patients, 8.6 percent visited medical institutions outside of the prefectures where the patients lived. Many patients living in prefectures located close to large cities, such as Tokyo, visited medical institutions in large cities. 2) The proportion of patients who visited hospitals of medical schools was 27.9 percent. 3) Patients who were affected by diseases causing physical disabilities such as SMON and malignant rheumatoid arthritis tended to visit medical institutions located in their neighborhoods and were treated in small hospitals or clinics. Old patients had the same tendency as patients with such diseases. 4) Although the number of patients receiving aid in 1988, whose data we analyzed in the current study, was larger than that in 1984, the proportion of patients visiting medical institutions outside of the prefecture where the patients lived, and the proportion of patients visiting hospitals of medical schools were nearly equal to those in 1984.
为了确定患有30种疑难疾病的患者所就诊医疗机构的特点，我们分析了难治性疾病研究委员会于1989年进行的一项全国性调查的数据。日本47个都道府县的政府各自报告了1988年4月至1989年3月期间接受过这些疾病经济援助的所有30种疑难疾病患者的信息。收集到的每位患者的信息包括识别号码，其中有疾病代码、性别、年龄、患者居住市町村的代码、治疗该患者的医疗机构等。在都道府县报告了信息的173,637名患者中，我们使用了159,910名医疗机构信息报告完整的患者的数据。结果可总结如下：1）在这159,910名患者中，8.6%的患者前往其居住都道府县以外的医疗机构就诊。许多居住在靠近大城市（如东京）的都道府县的患者前往大城市的医疗机构就诊。2）就诊于医学院校附属医院的患者比例为27.9%。3）患有诸如亚急性脊髓视神经病和恶性类风湿性关节炎等导致身体残疾疾病的患者倾向于前往其附近的医疗机构就诊，并在小型医院或诊所接受治疗。老年患者与患有此类疾病的患者有相同的倾向。4）尽管我们在本研究中分析的1988年接受援助的患者数量多于1984年，但前往其居住都道府县以外医疗机构就诊的患者比例以及就诊于医学院校附属医院的患者比例与1984年几乎相等。
