Tsuda Kenji, Tanimoto Tetsuya, Sakaue Saori, Sato Tomohiko, Kouno Kaduki, Hamaki Tamae, Hosoda Kazutaka, Ohnishi Mutsuko, Komatsu Tsunehiko, Kami Masahiro, Kusumi Eiji
Department of Hematology and Rheumatology, Teikyo University Chiba Medical Center, Chiba Department of Internal Medicine, Navitas Clinic, Tokyo Graduate School of Education, Seisa University, Kanagawa Department of Pediatrics, Navitas Clinic Medical Governance Research Institute, Tokyo, Japan.
Medicine (Baltimore). 2018 Jan;97(2):e9646. doi: 10.1097/MD.0000000000009646.
Hidden barriers to visit a medical facility especially for young busy workers have been neglected in the aging society. The aim of this cross-sectional study is to analyze demographics of patients who had visited the first known convenient clinic located inside a railway station, which is adjusted to the lifestyle of working generations.We analyzed de-identified data of patients who had visited the department of internal medicine of a clinic, which is located inside a railway station building and offers primary care with after-hours accessibility in Tokyo, between August 2013 and June 2016. Data were collected on patients' sex, age, time of visit, waiting time, presence or absence of an appointment, diagnosis, and patients' addresses using the electronic health and billing records.Overall, 28,001 patients visited 87,126 times. Number of visits increased in winter season compared with the other seasons. Sixty-one percent were women and the median age of all patients was 38 years (range, 0-102). The number of visits on Mondays was the highest in a week and the most frequent visiting time was between 6 and 7 p.m. The number of visits of working generations (from 15 to 65 years old) and men increased after 6 p.m. and on weekends. The 3 most common diagnoses were upper respiratory tract infection (22,457), allergic rhinitis (20,916), and hypertension (4869). The number of individuals who were referred to other medical institutions was 1022 (1.2%). The median waiting time was 748 seconds (range, 2-5344). The number of visits from within 2-, 5-, and 10-mile radius from our clinic was 41,696 (50.6%), 63,190 (76.7%), and 75,015 (91.1%), respectively, and patients' addresses were mainly located along the railway network.The locational and temporal convenience of our clinic has attracted the unmet medical demands especially for young workers who have difficulty in visiting conventional medical institutions.
在老龄化社会中，前往医疗机构就诊存在的隐性障碍，尤其是对忙碌的年轻工作者而言，一直被忽视。这项横断面研究的目的是分析前往位于火车站内的首个已知便捷诊所就诊的患者的人口统计学特征，该诊所适应了工作人群的生活方式。
我们分析了2013年8月至2016年6月期间在东京一座火车站大楼内的诊所内科就诊患者的去识别化数据，该诊所提供初级医疗服务且下班后也可就诊。使用电子健康和计费记录收集了患者性别、年龄、就诊时间、等待时间、是否预约、诊断结果以及患者住址等数据。
总体而言,28001名患者就诊87126次。与其他季节相比，冬季就诊次数增加。61%为女性，所有患者的年龄中位数为38岁(范围为0至102岁)。周一的就诊次数在一周中最高，最频繁的就诊时间是下午6点至7点。工作年龄段(15至65岁)的人群和男性在下午6点以后及周末的就诊次数增加。最常见的三种诊断是上呼吸道感染(22457例)、过敏性鼻炎(20916例)和高血压(4869例)。被转诊至其他医疗机构的人数为1022人(1.2%)。中位等待时间为748秒(范围为2至5344秒)。距离我们诊所2英里、5英里和10英里半径范围内的就诊人数分别为41696人(50.6%)、63190人(76.7%)和75015人(91.1%)，患者住址主要分布在铁路沿线。
我们诊所的位置和时间便利性吸引了那些难以前往传统医疗机构就诊的未满足医疗需求，尤其是年轻工作者。
