Seishima Ryo, Tachimori Hisateru, Fukuda Kazumasa, Ikeda Norihiko, Miyata Hiroaki, Fushimi Kiyohide, Kitagawa Yuko
Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan
BMJ Open. 2024 Dec 26;14(12):e084630. doi: 10.1136/bmjopen-2024-084630.
Lockdowns and outing restrictions during the COVID-19 pandemic may have altered attitudes towards hospital visits. This study aimed to investigate changes in long-distance visits outside of secondary healthcare service areas (SHSA) among cancer patients in Japan.
Retrospective observational study.
Inpatient data from the Japanese Diagnosis Procedure Combination database.
We retrospectively analysed inpatient data from January 2018 to December 2021, extracted from the Japanese Diagnosis Procedure Combination database. The study examined whether the patient's hospital was within their residence's SHSA and compared the admission rates before and after the pandemic.
The data of a total of 2 394 760 patients were analysed. Admission rates outside the SHSA significantly decreased after the pandemic compared with prepandemic years (26.67% and 27.58%, respectively, p<0.001). Significant reductions were observed in nearly all age groups over 30 years old, but not in younger ones. Characteristics of patients' residences, including COVID-19 infection rates, population density and the number of regional cancer hospitals, were also influential factors. The cancer site was a significant factor, with the respiratory system showing a 3.77% decrease, particularly a 5.29% decrease in those who needed surgeries that are not highly specialised (p<0.001).
Admission to distant hospitals among cancer patients decreased following the COVID-19 pandemic, indicating a restraint in their behaviour of visiting distant hospitals. The appropriate allocation of specialised hospitals will serve as a measure for the next pandemic.
2019冠状病毒病大流行期间的封锁措施和出行限制可能改变了人们对就医的态度。本研究旨在调查日本癌症患者前往二级医疗服务区域（SHSA）以外地区进行长途就医的变化情况。
回顾性观察研究。
来自日本诊断程序组合数据库的住院患者数据。
我们回顾性分析了从日本诊断程序组合数据库中提取的2018年1月至2021年12月的住院患者数据。该研究检查了患者就诊的医院是否在其居住地的SHSA范围内，并比较了疫情前后的住院率。
共分析了2394760例患者的数据。与疫情前相比，疫情后SHSA以外地区的住院率显著下降（分别为26.67%和27.58%，p<0.001）。在几乎所有30岁以上的年龄组中都观察到了显著下降，但在较年轻的年龄组中没有。患者居住地的特征，包括新冠病毒感染率、人口密度和地区癌症医院数量，也是影响因素。癌症部位是一个重要因素，呼吸系统的住院率下降了3.77%，特别是那些需要进行非高度专业化手术的患者下降了5.29%（p<0.001）。
2019冠状病毒病大流行后，癌症患者前往外地医院就医的情况减少，这表明他们前往外地医院就医的行为受到了限制。合理分配专科医院将作为应对下一次大流行的一项措施。
