Study identifies regional disparities in home health care utilization for older adults and their associated factors

The establishment of home care support clinics and hospitals (HCSCs) between 2006 and 2008 was intended to improve home health care in Japan, with a system for doctors to receive calls on a 24-hour basis and visit patients at home (home visits). The subsequent establishment of enhanced HCSCs in 2012 was intended to further promote both home visits for people who suddenly become ill and end-of-life care at home.

However, the effects of these measures may differ depending on the region. Local differences in the number of these facilities are also likely linked to regional disparities in the rate of home health care use.

A new study published in Geriatrics & Gerontology International by researchers at the University of Tsukuba focused on identifying regional differences in the rate of use of physician-led home-visit medical care among people aged 65 and above using nationwide data published by the Ministry of Health, Labor and Welfare.

Through analyzing publicly available data from the Ministry of Health, Labor and Welfare, they determined that older adults had a higher rate of home-visit medical care use in areas with high population densities, such as Tokyo and Osaka. Differences also depended on the area of residence, with higher rates of home-visit medical care use in the Kanto, Chubu, Kinki, and Chugoku regions than in Hokkaido and Tohoku.

In addition, the proportion of older adults receiving home-visit medical care, mainly from enhanced HCSCs, was higher in urban areas. However, in less populated areas, the proportion of older adults receiving home visits was low, with more people using conventional HCSCs.

Furthermore, multivariate analysis showed that the proportion of older adults receiving home visits was high in areas with high population densities, particularly those with a large number of conventional HCSCs and enhanced HCSCs, while it was low in areas with many beds in long-term care facilities.

These results reveal significant regional disparities in the frequency of home visits among older adults. Furthermore, they indicate a relationship between medical and long-term care resources, population density, and residential area. In the context of Japan’s aging population, these results highlight the importance of recognizing these regional disparities and developing a health care and long-term care provision system that is tailored to regional characteristics.