Doi Shunsuke, Ide Hiroo, Takeuchi Koichi, Fujita Shinsuke, Takabayashi Katsuhiko
Department of Healthcare and Information Management, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Department of Welfare and Medical Intelligence, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan.
Int J Environ Res Public Health. 2017 Nov 10;14(11):1367. doi: 10.3390/ijerph14111367.
Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the patient access area model (PAAM), which simulates patients' access time to healthcare service institutions using a geographic information system (GIS). Using this model, to evaluate the balance of future healthcare services demand and supply in small areas, we estimated the number of inpatients every five years in each area and compared it with the number of hospital beds within a one-hour drive from each area. In an experiment with the Tokyo metropolitan area as a target area, when we assumed hospital bed availability to be 80%, it was predicted that over 78,000 inpatients would not receive inpatient care in 2030. However, this number would decrease if we lowered the rate of inpatient care by 10% and the average length of the hospital stay. Using this model, recommendations can be made regarding what action should be undertaken and by when to prevent a dramatic increase in healthcare demand. This method can help plan the geographical resource allocation in healthcare services for healthcare policy.
获得医疗服务提供者的机会、其数量和质量对国民健康至关重要。在本研究中,我们专注于地理可达性,以估计和评估未来医疗服务的需求和供应。我们构建了一个名为患者可达区域模型(PAAM)的模拟模型,该模型使用地理信息系统(GIS)模拟患者前往医疗服务机构的时间。使用该模型,为了评估小区域内未来医疗服务需求和供应的平衡,我们估计了每个区域每五年的住院患者数量,并将其与距每个区域一小时车程内的医院病床数量进行比较。在以东京都市区为目标区域的实验中,当我们假设病床可用性为80%时,预计到2030年将有超过78000名住院患者无法获得住院治疗。然而,如果我们将住院治疗率降低10%并缩短平均住院时间,这个数字将会下降。使用该模型,可以就应该采取什么行动以及何时采取行动以防止医疗需求急剧增加提出建议。这种方法有助于为医疗政策规划医疗服务中的地理资源分配。