Akamatsu Yuri, Ojima Toshiyuki, Fukunaga Ichiro, Ohsaka Goro, Saeki Keigo, Shimamura Michiko, Shirai Chika, Nagai Hitomi, Miyazono Masaya, Uchida Katsuhiko
Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine.
Department of Health Informatics, School of Public Health, Kyoto University.
Nihon Koshu Eisei Zasshi. 2024 Mar 19;71(3):167-176. doi: 10.11236/jph.23-064. Epub 2023 Dec 21.
Objectives The primary aim of this study was to clarify the relationship between the number of public health nurses (PHNs) and the total number of people who received home-visit nursing services for mental health or intractable diseases. The secondary aim was to clarify the extent of regional differences in the number of PNHs and mental health or intractable diseases.Methods This study used the total number of people who received home-visit nursing services for mental health or intractable diseases in 2019 from the Portal Site of Official Statistics of Japan (e-Stat) and population and area data in January 2020. Single and multiple regression analyses (covariates: population and area) were performed on the relationship between the number of PHNs per 100,000 population (abbreviated as "ratios of PHNs") and the total number of people who received home-visit nursing services for mental health or intractable diseases per 100,000 population (abbreviated as "mental health/intractable disease achievements"). Regional differences in ratios of PHNs and mental health/intractable disease achievement were examined using mean, standard deviation, maximum/minimum values, and Gini coefficients. Analyses were performed for each of the five units: the prefectures as a whole, prefectural public health centers, municipalities within the jurisdiction of prefectural public health centers, and cities in which public health centers are established (including or not including special wards).Results Regression analyses indicated a positive relationship between the ratios of PHNs and mental health/intractable disease achievements. Multiple regression analysis indicated that both achievements were positively associated with population size and negatively associated with area size. The largest regression coefficients between the ratios of PHNs and achievements were 34.07 and 5.48 regarding mental health achievements and intractable disease achievements, respectively. For regional differences, the smallest Gini coefficient was the ratios of PHNs, and the largest was intractable disease achievements. The smallest and largest coefficient of the prefectures as a whole was 0.15 and 0.34, respectively. The maximum/minimum values of the prefectures as a whole also indicated that the smallest was 3.8 in the ratio of PHNs and the largest was 30.0 in intractable disease achievement.Conclusions Increasing number of PHNs is needed to provide more home-visit nursing services for mental health and intractable diseases. It is particularly important to fill up the larger number of PHNs in smaller populations or larger area prefectures. Due to regional differences in the home-visit nursing service, it is important to promote the increase in the level of these activities.
目的 本研究的主要目的是阐明公共卫生护士(PHN)数量与接受心理健康或难治性疾病家庭访视护理服务的总人数之间的关系。次要目的是阐明PHN数量以及心理健康或难治性疾病方面的地区差异程度。
方法 本研究使用了来自日本官方统计门户网站(e-Stat)的2019年接受心理健康或难治性疾病家庭访视护理服务的总人数,以及2020年1月的人口和面积数据。对每10万人口中的PHN数量(简称为“PHN比率”)与每10万人口中接受心理健康或难治性疾病家庭访视护理服务的总人数(简称为“心理健康/难治性疾病成果”)之间的关系进行了单因素和多因素回归分析(协变量:人口和面积)。使用均值、标准差、最大值/最小值和基尼系数来检验PHN比率和心理健康/难治性疾病成果的地区差异。对五个单位分别进行了分析:整个县、县公共卫生中心、县公共卫生中心管辖范围内的市,以及设有公共卫生中心的城市(包括或不包括特别区)。
结果 回归分析表明PHN比率与心理健康/难治性疾病成果之间存在正相关关系。多因素回归分析表明,这两项成果均与人口规模呈正相关,与面积规模呈负相关。PHN比率与成果之间的最大回归系数在心理健康成果方面为34.07,在难治性疾病成果方面为5.48。对于地区差异,最小的基尼系数是PHN比率,最大的是难治性疾病成果。整个县的最小和最大系数分别为0.15和0.34。整个县的最大值/最小值也表明,最小的是PHN比率中的3.8,最大的是难治性疾病成果中的30.