Department of Global Health Promotion, Tokyo Medical and Dental University.
Department of Medical Education Research and Development, Tokyo Medical and Dental University.
J Epidemiol. 2022 Feb 5;32(2):80-88. doi: 10.2188/jea.JE20200211. Epub 2021 Apr 23.
Japan's historically low immigration rate and monolingual culture makes it a particularly interesting setting for clarifying non-national medical care. Our study objective was to examine disease patterns and outcome differences between Japanese and non-Japanese patients in a rapidly globalizing nation.
A secondary data analysis of 325 non-Japanese and 13,370 Japanese patients requiring tertiary care or intensive-care unit or high-care unit admission to the emergency department at the Tokyo Medical and Dental University medical hospital from 2010 through 2019 was conducted. Multivariable linear and logistic regressions models were applied to examine differences in percentage of diagnosis, mortality rates, and length of stay, stratified by Glasgow Coma Scale (GCS) scores to consider the impact of language barriers. Sex and age were adjusted.
Non-Japanese patients had more anaphylaxis, burns, and infectious disease, but less cardiovascular diagnoses prior to adjustment. After adjustment, there were significantly more anaphylaxis (adjusted odds ratio [aOR] 2.7; 95% confidence interval [CI], 1.7-4.4) and infectious disease diagnoses (aOR 2.2; 95% CI, 1.3-3.7), and marginally more burn diagnoses (aOR 2.3; 95% CI, 0.96-5.3) than Japanese patients. Regardless of GCS scores, there were no significant differences between non-Japanese and Japanese patient length of stay for anaphylaxis, burn, and infectious disease after covariate adjustment.
There were more non-Japanese patients diagnosed with anaphylaxis, burns, and infectious disease, but no notable patient care differences for length of stay. Further prevention efforts are needed against anaphylaxis, burns, and infectious disease for non-Japanese tourists or residents.
日本历史上的低移民率和单一语言文化使其成为澄清非本国医疗保健的一个特别有趣的环境。我们的研究目的是在一个快速全球化的国家中，研究日本人和非日本人患者之间的疾病模式和结果差异。
对 2010 年至 2019 年期间在东京医科齿科大学附属医院急诊需要三级护理或重症监护或高级护理单元入院的 325 名非日籍和 13370 名日籍患者进行了二次数据分析。应用多变量线性和逻辑回归模型，按格拉斯哥昏迷量表（GCS）评分分层，以考虑语言障碍的影响，检验诊断百分比、死亡率和住院时间的差异。调整了性别和年龄。
非日籍患者在调整前更易发生过敏反应、烧伤和传染病，但心血管疾病的诊断较少。调整后，过敏反应（调整后的优势比[OR]2.7；95%置信区间[CI]1.7-4.4）和传染病诊断（调整后的 OR 2.2；95%CI1.3-3.7）明显更多，烧伤诊断略多（调整后的 OR 2.3；95%CI0.96-5.3）。无论 GCS 评分如何，在调整协变量后，非日籍和日籍患者的过敏反应、烧伤和传染病的住院时间均无显著差异。
非日籍患者被诊断出过敏反应、烧伤和传染病的人数更多，但在住院时间方面没有明显的患者护理差异。需要进一步加强对非日籍游客或居民的过敏反应、烧伤和传染病的预防工作。
