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老年患者的跨境流动:关于在泰国的日本退休人员医疗服务利用情况的描述性研究。

Cross-border movement of older patients: a descriptive study on health service use of Japanese retirees in Thailand.

作者信息

Miyashita Yumiko, Akaleephan Chutima, Asgari-Jirhandeh Nima, Sungyuth Channarong

机构信息

International Health Policy Program, Thailand, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand.

World Health Organization, Regional Office for South East Asia, World Health House, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi, 110002, India.

出版信息

Global Health. 2017 Mar 8;13(1):14. doi: 10.1186/s12992-017-0241-9.

Abstract

BACKGROUND

Thailand's policy to promote long-stay tourism encourages Japanese retirees to relocate to Thailand. One concern of such an influx is the impact of these elderly foreign residents on the Thai health system. This study aims to reveal the current use of and needs for health services amongst Japanese retirees residing in various locations in Thailand.

METHODS

In collaboration with nine Japanese self-help clubs in Bangkok, Chiang Mai, Chiang Rai, and Phuket, questionnaire surveys of Japanese long-stay retirees were conducted from January to March 2015. The inclusion criteria were being ≥ 50 years of age and staying in Thailand for ≥30 days in the previous 12 months while the main exclusion criteria included relocation by company, relocation due to marriage, or working migrants.

RESULTS

The mean age of the 237 eligible participants was 68.8, with 79.3% of them being male, 57.8% having stayed in Thailand for ≥5 years, 63.3% having stayed in Thailand for ≥300 days in the previous 12 months and 33% suffering from chronic diseases or sequelae. Of the 143 who had health check-ups in the previous 12 months, 48.3% did so in Thailand. The top 3 diseases treated either in Thailand or Japan in the previous 12 months were dental diseases (50 patients), hypertension (44 patients), and musculoskeletal disorders (41 patients), with the rate of treatment in Thailand standing at 46.0, 47.7, and 65.9%, respectively. Of the 106 who saw a doctor in Thailand in the same period, 70.8% did so less than once a month. Only 23.2% of the participants preferred to receive medical treatment for serious conditions in Thailand. However, this number rose to 32.9% for long-term care (LTC) use.

CONCLUSION

The usage of Thai health services amongst Japanese long-stay retirees is currently limited as they prefer going back to Japan for health screenings and treatment of chronic or serious diseases. However, the number of Japanese residents requiring health services including LTC and end-of-life care is expected to increase. The potential impact of promoting long-stay tourism on the Thai public health should be acknowledged and investigated by the Thai government, including the tourism authority.

摘要

背景

泰国促进长期旅游的政策鼓励日本退休人员移居泰国。这种人员涌入引发的一个担忧是这些外国老年居民对泰国医疗系统的影响。本研究旨在揭示居住在泰国各地的日本退休人员目前对医疗服务的使用情况和需求。

方法

2015年1月至3月,与曼谷、清迈、清莱和普吉的9个日本自助俱乐部合作,对长期居住的日本退休人员进行了问卷调查。纳入标准为年龄≥50岁且在过去12个月内在泰国停留≥30天,主要排除标准包括因公司调动、因结婚而迁移或工作移民。

结果

237名符合条件的参与者的平均年龄为68.8岁,其中79.3%为男性,57.8%在泰国停留≥5年,63.3%在过去12个月内在泰国停留≥300天,33%患有慢性病或后遗症。在过去12个月内进行过健康检查的143人中,48.3%在泰国进行。过去12个月内在泰国或日本接受治疗的前三大疾病是牙科疾病(50例患者)、高血压(44例患者)和肌肉骨骼疾病(41例患者),在泰国的治疗率分别为46.0%、47.7%和65.9%。在同一时期在泰国看过医生的106人中,70.8%的人每月看诊次数少于一次。只有23.2%的参与者倾向于在泰国接受严重疾病治疗。然而,长期护理(LTC)使用的这一比例上升至32.9%。

结论

目前,长期居住的日本退休人员对泰国医疗服务的使用有限,因为他们更愿意返回日本进行健康检查和治疗慢性病或严重疾病。然而,包括长期护理和临终关怀在内,需要医疗服务的日本居民数量预计将会增加。泰国政府,包括旅游当局,应认识到并调查促进长期旅游对泰国公共卫生的潜在影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8563/5343304/17c68be78b66/12992_2017_241_Fig1_HTML.jpg

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