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日本におけるヘルスケア利用に影響する要因 Factors Affecting Health Care Utilization for Children in Japan

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2012年01月23日(Mon) 16:51 by drharasho

先天性甲状腺機能低下症の診療とは直接関係有りませんが、
米国小児科学会雑誌に日本の小児医療に関する
興味深い論文が載りました。

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 日本の小児は、成人より約2倍(人口1000人当たり)多く診療所の外来を受診、
米国の小児との比較では、診療所受診は約2.5倍、病院外来は約11倍に上る。
また、小児の受診率は年齢が低いほど高いが、親の収入や地域による差は見られなかった……。

 これは、聖路加国際病院小児科医長の石田也寸志氏らが、Pediatrics誌に発表した
データです(Pediatrics 2012;129(1):e113-119. AbstractはPediatrics誌を参照)。詳細は、
原文をお読みいただきたいのですが、調査対象は1286世帯の1024人の小児。病院勤務医
の負担軽減の関連で、外来患者の多さが指摘される中、興味深い発表です。

 小児の医療費助成を導入する自治体は、少子化対策として、年々増加しています。
また対象年齢も3歳未満、小学校就学前、小学生、中学生と広がる傾向に。小児の
受診率が高いのは、この医療費助成が一因だと言えるでしょう。

Factors Affecting Health Care Utilization for Children in Japan
http://pediatrics.aappublications.org/content/129/1/e113.abstract

Background And Objective: Studies on the ecology of medical care for children
have been reported only from the United States. Our objective was to describe
proportions of children receiving care in 6 types of health care utilization seeking
 behaviors in Japan on a monthly basis and to identify care characteristics.

Methods: A population-weighted random sample from a nationally representative
panel of households was used to estimate the number of health-related symptoms,
over-the-counter medicine doses, and health care utilizations per 1000 Japanese
children per month. Variations in terms of age, gender, socioeconomic status, and
residence location were also examined.

Results: Based on 1286 households (3477 persons including 1024 children) surveyed,
on average per 1000 children, 872 had at least 1 symptom, 335 visited a physician's
office, 82 a hospital-based outpatient clinic, 21 a hospital emergency department,
and 2 a university-based outpatient clinic. Two were hospitalized, and 4 received
professional health care in their home. Children had 2 times more physician visits
and 3 times more emergency visits than adults in Japan, and Japanese children
had 2.5 times more physician visits and 11 times more hospital-based outpatient
clinic visits than US children. Pediatric health care utilization is influenced significantly
 by age but not affected by income or residence location in Japan.

Conclusions Compared with the data from the United States, more children in Japan
visit community physicians and hospital-based outpatient clinics. Results of this study
would be useful for further delineation of health care utilization of children in the
context of a health care system unique to Japan.

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