A Time-series Analysis of Hospital Choice Behavior of Inpatients

Research Project

Project/Area Number	63460181
Research Category	Grant-in-Aid for General Scientific Research (B)
Allocation Type	Single-year Grants
Research Field	建築計画・都市計画
Research Institution	University of Tsukuba
Principal Investigator	TANIMURA Hidehiko University of Tsukuba, Institute of Socio-Economic Planning, Professor, 社会工学系, 教授 (40111356)
Co-Investigator(Kenkyū-buntansha)	TOMIE Shinji University of Tsukuba, Institute of Art and Design, Assistant Professor, 芸術学系, 助教授 (10015985) KURIHARA Kaichiro University of Tsukuba, Institute of Art and Design, Professor, 芸術学系, 教授 (70015957)
Project Period (FY)	1988 – 1989
Project Status	Completed (Fiscal Year 1989)
Budget Amount *help	¥5,300,000 (Direct Cost: ¥5,300,000) Fiscal Year 1989: ¥1,500,000 (Direct Cost: ¥1,500,000) Fiscal Year 1988: ¥3,800,000 (Direct Cost: ¥3,800,000)
Keywords	time-series analysis / hospital choice behavior / inpatients / Hiroshima / 地域医療計画 / 広島県
Research Abstract	This study hypothesizes that the hospital choice behavior of impatients is dynamically changing from one time to another in accordance with a combination of factors such as the level of medical services provided in the region, aging of the population, increasingly higher level of demand for medical services commensurate with the better standard of living, ease of transportation and so on. The time-series analysis, however, requires at least two sets of hospital choice surveys taken in the same region. Because this data requirement has been rarely satisfied, past studies of hospital choice behavior have been mostly static. Accordingly, the data availability of hospital choice surveys in 1973 and 1984 in Hiroshima Prefecture has prompted this study. For each survey data, an origin-destination matrix of in- patients is prepared and analyzed by means of a cluster analysis based on the minimum information loss as the indicator of proximity. Between the two dates, the mean daily patient-days per 1000 population increased from 8.96 to 10.78, an increase of 1.82. Seventy percent of this gain, however, can be accounted for by the aging factor of population. Average distances between residences of patients and locations of hospitals had been moderately shortened from 7.71 km to 7.53 km among patients 65 years of age or older, from 11.00 km to 9.17 km among patients between 64 and 16 years of age, and from 18.44 km to 15.92 km among patients 15 years or younger. In spite of the improvements in the prefectural averages, however, figures for the remote rural areas had deteriorated. Health-care provision for aged patients in the depopulating rural areas of the Prefecture is increasingly becoming a critical issue.