Health care system in the era of population decline-Learning from depopulated municipalities

• Project/Area Number: 17K18048
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Medical sociology; Social welfare and social work studies
• Research Institution: Tokai University (2018-2019); Jichi Medical University (2017)
• Principal Investigator: KOJO TAKAO 東海大学, 健康学部, 准教授 (70518787)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000); Fiscal Year 2018: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: 地域医療 / へき地医療 / 医療瀬策 / 過疎市町村 / 人口減少 / 無医地区 / 医療政策

Outline of Final Research Achievements

The purpose of this study is to "analyze the impact of population decline, low birthrate and aging population on health care delivery system and health level." At the prefectural and municipal levels, the period and factors behind the decline in the population became clear, and it was revealed that the population decline may have a negative impact on some mortality rates, although it depends on gender.
It has been confirmed that due to the declining population, it has turned to a no-doctor district and that some districts have not been recognized as the no-doctor districts due to fewer than 50 people. It was found that the number of regions where the population is decreasing bellow 50 is increasing. In addition, with the cooperation of the prefecture and municipals, we were able to carry out a regional diagnostic sheet and a survey of residents to understand the current situation in the remote areas.

Academic Significance and Societal Importance of the Research Achievements

これまでの人口減少の進展状況を、都道府県レベル、市区町村レベルで分析し、地域の健康指標への影響が出ている可能性についても明らかにすることができた。地区の人口が50人未満になり無医地区の指定を外れるほど、人口減少が深刻している現状も把握できた。さらに、へき地を支援する県、医療機関とへき地を有する市町と共同研究会を開催することで、立場を超えた協働活動（情報交換や調査）を後押しできたことは、社会的意義があったと思われる。

Research Products

• [Journal Article] Retention of qualified health professionals in rural area: a case control study (2018)
  • Author(s): Takao kojo and colleagues
  • Journal Title: Africa Health Volume: 40(4) Pages: 21-25
  • Open Access / Int'l Joint Research
• [Presentation] 垣根を超えてへき地医療の将来を考える共同研究会の取り組み（第1報） (2019)
  • Author(s): 古城隆雄, 原田 昌範, 中嶋 裕, 宮野 馨, 横田 哲,鱸南 富美子, 林 加代子, 佐伯 賢紀, 石田 典子, 藤堂修, 礒辺 一
  • Organizer: 第10回日本プライマリ・ケア連合学会学術大会
• [Presentation] Health care access issues caused by aging population/decline in no-doctor districts. (2017)
  • Author(s): Takao Kojo, Soichiro Mitani, Ryusuke Ae, Kazuhiko Kotani, Ichiro Innami
  • Organizer: WONCA Asia Pacific October 2017,
  • Int'l Joint Research
• [Presentation] What are determinants to influence retention of qualified human resources for health in rural and difficult regions in Senegal? (2017)
  • Author(s): Takao Kojo, Mari Nagai, Malik Salla, Ibrahima Souka Ndella Diouf, Noriko Fujita.
  • Organizer: The 21st World Congress of Epidemiology-World Congress Epidemiology2017
  • Int'l Joint Research