Yamashita M
College of Nursing and Science, Hyogo.
Nihon Koshu Eisei Zasshi. 1998 Mar;45(3):225-39.
The per capita medical expense was studied for inpatients and outpatients aged 70 years and over under the National health insurance for fiscal year 1990 among 678 cities in Japan. Per capita medical expense consists of three factors, i.e. service-acceptance rate, bed-days per receipt and the medical expense per day. To clarify what factors are associated with these three factors of the medical expense, multiple regression analyses were performed using several indices of medical supply and medical need, family type, health projects and socioeconomics. The results are as follows. (1) The major factor that was correlated significantly and positively with the expense and service-acceptance rate for inpatients was medical supply. (2) Both the bed-days receipt and the service-acceptance rate for inpatients were negatively correlated with cerebral apoplexy. (3) Medical expenses per day for inpatients and outpatients were negatively correlated with medical supply, such as the number of hospitals per population. (4) The major factor that was correlated positively with medical expenses for outpatients was medical need, such as cancer and heart disease. (5) Service-acceptance rate of outpatients was correlated positively with the factors of accessibility, such as number of medical institutions per area. (6) Days per receipt of outpatients was correlated negatively with the level of health among cities.
对日本678个城市1990财年国民健康保险覆盖下70岁及以上住院患者和门诊患者的人均医疗费用进行了研究。人均医疗费用由三个因素构成，即服务接受率、每次就诊的住院天数和每日医疗费用。为了阐明哪些因素与医疗费用的这三个因素相关，使用了医疗供给和医疗需求的若干指标、家庭类型、健康项目以及社会经济状况进行了多元回归分析。结果如下：(1) 与住院患者费用和服务接受率显著正相关的主要因素是医疗供给。(2) 住院患者的每次就诊住院天数和服务接受率均与脑中风呈负相关。(3) 住院患者和门诊患者的每日医疗费用与医疗供给呈负相关，如每人口医院数量。(4) 与门诊患者医疗费用正相关的主要因素是医疗需求，如癌症和心脏病。(5) 门诊患者的服务接受率与可及性因素呈正相关，如每地区医疗机构数量。(6) 门诊患者每次就诊天数与城市间的健康水平呈负相关。
