[Medical expenditure for the elderly and factors related to its geographical variations within Fukuoka Prefecture].

Using national health insurance data in 1992, medical expenditure for the elderly in Fukuoka Prefecture were compared with that in all of Japan, and analyzed for relationships to several socioeconomic factors, medical supply, medical needs, and health care and welfare services using univariate and multivariate analyses to clarify factors related to geographical variations in medical expenditure within Fukuoka Prefecture. The results were as follows: 1) Compared to national average, Fukuoka Prefecture showed 43% higher per capita medical expenditure for inpatients, despite slightly lower inpatient medical expenditure per day. For outpatients, per capita medical expenditure in Fukuoka Prefecture was similar to national average. 2) Of the elderly aged 70 or over, 6.7% had hospitalizations of durations exceeding six months with over half of these being hospitalized for the entire year. Circulatory diseases, particularly stroke, were the most important cause for long-term hospitalization. 3) In both univariate and multivariate analyses of geographical variations, per capita inpatient medical expenditure was correlated positively with the number of hospital beds per 100,000 and negatively with the average number of persons per household. In the multivariate analyses, per capita inpatient medical expenditure was not correlated with all-cause death rates for the elderly aged 70 or over, an index of medical needs. This suggests that factors other than medical needs contribute greatly to the hospitalization of elderly. In both univariate and multivariate analyses, per capita outpatient medical expenditure showed a significantly positive correlation with all-cause death rates for the elderly aged 70 or over and negative with rates of participation in general health checkups.