Fu Rong, Liu Sizhe, Oikawa Masato, Noguchi Haruko, Kawamura Akira
Faculty of Commerce, Waseda University, Shinjuku, Japan.
Graduate School of Commerce, Waseda University, Shinjuku, Japan.
Sci Rep. 2025 Apr 22;15(1):13813. doi: 10.1038/s41598-025-98908-x.
This study examines healthcare utilization patterns among Japan's older population (aged 75 and above) during a prolonged public health emergency, focusing on the later phase of the COVID-19 pandemic (November 2021-September 2022). This period was characterized by the Omicron variant, widespread vaccination coverage, and adapted public health measures. Using a comprehensive dataset of 189,841,257 medical claims linked with income tax records, we analyze how healthcare utilization correlates with public health measures, pandemic severity, and income levels. Our findings reveal distinct utilization patterns: moderate decreases in healthcare visits during periods of public health measures, with the association between pandemic severity and healthcare use varying based on whether these measures are in place. Despite fluctuations in visit frequency, healthcare costs remain stable, indicating consistent service intensity. While income-related differences in general healthcare access are modest, dental care shows more pronounced socioeconomic variations. These patterns suggest a transition from initial widespread healthcare avoidance to more stable healthcare engagement, indicating adaptation to prolonged crisis conditions. Our findings provide insights for maintaining healthcare access during extended public health emergencies, particularly in aging societies where balancing healthcare needs with public health measures is crucial.
本研究考察了在长期公共卫生紧急事件期间，日本老年人口（75岁及以上）的医疗服务利用模式，重点关注新冠疫情的后期阶段（2021年11月至2022年9月）。这一时期的特点是奥密克戎变异株、广泛的疫苗接种覆盖率以及适应性的公共卫生措施。我们使用了一个包含1.89841257亿份与所得税记录相关的医疗报销申请的综合数据集，分析医疗服务利用与公共卫生措施、疫情严重程度和收入水平之间的关联。我们的研究结果揭示了不同的利用模式：在公共卫生措施实施期间，医疗就诊次数适度减少，疫情严重程度与医疗服务使用之间的关联因这些措施是否实施而有所不同。尽管就诊频率有所波动，但医疗费用保持稳定，表明服务强度一致。虽然在一般医疗服务可及性方面与收入相关的差异不大，但牙科护理在社会经济方面的差异更为明显。这些模式表明从最初广泛的医疗回避向更稳定的医疗参与转变，这表明适应了长期危机状况。我们的研究结果为在长期公共卫生紧急事件期间维持医疗服务可及性提供了见解，特别是在老龄化社会中，平衡医疗需求与公共卫生措施至关重要。
