Kazuaki Miyagishima1, Takeshi Kawaguchi. 1. Department of Public Health, Faculty of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan. miyagishima-kazuaki@umin.ac.jp
Abstract
OBJECTIVE: In this study, we aimed at examining how disparities in selected medical care resources across secondary medical care sectors (SMCSs) changed over a twelve-year period following the introduction of the Medical Care Plan. METHODS: Changes in all SMCS boundaries prior to 2002 were identified from data published by the Ministry of Health and Welfare and prefectural governments. The per capita numbers of ordinary hospital beds and X-ray computed tomography (CT) scanners in hospitals were chosen as indicators of medical care resources, representing respectively mandatory and nonmandatory components of the Medical Care Plan. Their interquartile range and quartile variation coefficient were used as measures of disparity among SMCSs. RESULTS: The number of ordinary hospital beds per capita did not increase significantly between 1988 and 2000 in Group-A SMCSs (population density > or = 1000/km2) but increased significantly in Group-R (population density < 300/km2) and Group-U (300/km2 < or = population density < 1000/km2) SMCSs. The disparity in the per capita numbers of hospital beds among all SMCSs however decreased as a whole. The per capita numbers of X-ray CT scanners increased significantly in all three groups of SMCSs between 1987 and 1999. The coefficient of quartile variation for X-ray CT scanners remained larger than that for ordinary hospital beds over the 12-year period with the exception of Group-A SMCSs. CONCLUSIONS: The disparities in medical care resources among SMCSs decreased for ordinary hospital beds more markedly than for X-ray CT scanners, possibly as an effect of the implementation of the Medical Care Plan.
OBJECTIVE: In this study, we aimed at examining how disparities in selected medical care resources across secondary medical care sectors (SMCSs) changed over a twelve-year period following the introduction of the Medical Care Plan. METHODS: Changes in all SMCS boundaries prior to 2002 were identified from data published by the Ministry of Health and Welfare and prefectural governments. The per capita numbers of ordinary hospital beds and X-ray computed tomography (CT) scanners in hospitals were chosen as indicators of medical care resources, representing respectively mandatory and nonmandatory components of the Medical Care Plan. Their interquartile range and quartile variation coefficient were used as measures of disparity among SMCSs. RESULTS: The number of ordinary hospital beds per capita did not increase significantly between 1988 and 2000 in Group-A SMCSs (population density > or = 1000/km2) but increased significantly in Group-R (population density < 300/km2) and Group-U (300/km2 < or = population density < 1000/km2) SMCSs. The disparity in the per capita numbers of hospital beds among all SMCSs however decreased as a whole. The per capita numbers of X-ray CT scanners increased significantly in all three groups of SMCSs between 1987 and 1999. The coefficient of quartile variation for X-ray CT scanners remained larger than that for ordinary hospital beds over the 12-year period with the exception of Group-A SMCSs. CONCLUSIONS: The disparities in medical care resources among SMCSs decreased for ordinary hospital beds more markedly than for X-ray CT scanners, possibly as an effect of the implementation of the Medical Care Plan.