Department of Pediatrics, St. Luke's International Hospital, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan.
Pediatrics. 2012 Jan;129(1):e113-9. doi: 10.1542/peds.2011-1321. Epub 2011 Dec 26.
Studies on the ecology of medical care for children have been reported only from the United States. Our objective was to describe proportions of children receiving care in 6 types of health care utilization seeking behaviors in Japan on a monthly basis and to identify care characteristics.
A population-weighted random sample from a nationally representative panel of households was used to estimate the number of health-related symptoms, over-the-counter medicine doses, and health care utilizations per 1000 Japanese children per month. Variations in terms of age, gender, socioeconomic status, and residence location were also examined.
Based on 1286 households (3477 persons including 1024 children) surveyed, on average per 1000 children, 872 had at least 1 symptom, 335 visited a physician's office, 82 a hospital-based outpatient clinic, 21 a hospital emergency department, and 2 a university-based outpatient clinic. Two were hospitalized, and 4 received professional health care in their home. Children had 2 times more physician visits and 3 times more emergency visits than adults in Japan, and Japanese children had 2.5 times more physician visits and 11 times more hospital-based outpatient clinic visits than US children. Pediatric health care utilization is influenced significantly by age but not affected by income or residence location in Japan.
Compared with the data from the United States, more children in Japan visit community physicians and hospital-based outpatient clinics. Results of this study would be useful for further delineation of health care utilization of children in the context of a health care system unique to Japan.
有关儿童医疗保健生态学的研究仅来自美国。我们的目的是描述日本儿童在 6 种卫生保健利用行为中接受保健的比例，并确定保健特征。
利用全国代表性家庭小组的人口加权随机抽样，估计每 1000 名日本儿童每月出现健康相关症状的次数、非处方药物剂量和卫生保健利用次数。还检查了年龄、性别、社会经济地位和居住地点的差异。
基于对 1286 户家庭（包括 3477 人，其中 1024 人为儿童）的调查，平均每 1000 名儿童中，有 872 人至少出现 1 种症状，335 人去看医生，82 人去医院门诊，21 人去医院急诊，2 人去大学门诊。有 2 人住院，4 人在家中接受专业保健。与日本成年人相比，日本儿童看医生的次数是成年人的两倍，看急诊的次数是成年人的三倍，日本儿童看医生的次数是美国儿童的 2.5 倍，去医院门诊的次数是美国儿童的 11 倍。日本儿童的医疗保健利用受年龄影响显著，但不受收入或居住地点影响。
与美国的数据相比，日本有更多的儿童去看社区医生和医院门诊。本研究的结果有助于进一步阐明日本独特的医疗保健体系中儿童的医疗保健利用情况。
