Effect of the 2016 Kumamoto earthquakes on preventable hospital admissions: a retrospective cohort study in Japan

Abstract

Background and objectivesThe Kumamoto earthquakes struck Kumamoto prefecture, in the southwest part of Japan in April 2016. Physical and mental disorders presenting to hospital increased after the 2016 Kumamoto earthquakes. Impaired access to primary care due to the earthquakes may have contributed to this increase. However, it is not known whether the 2016 Kumamoto earthquakes affected access to primary care. The objective of the present study was to investigate the impact of the 2016 Kumamoto earthquakes on short-term health conditions by analysing ambulatory care sensitive conditions (ACSCs), using administrative data from Kumamoto prefecture.DesignA retrospective cohort study.SettingResidents enrolled in National Health Insurance or Late Elders’ Health Insurance from Kumamoto prefecture, Japan.ParticipantsAll hospital admissions due to ACSCs between 15 March and 16 May in each year from 2013 to 2016.Outcome measuresACSCs are defined as conditions for which appropriate primary care interventions could prevent admission to the hospital.ResultsWe identified a total of 7921, 18 763 and 85 436 admissions for vaccine, acute and chronic preventable ACSCs, respectively, during the study period. Admissions within 7 days after the 2016 Kumamoto earthquakes increased to 32.6% (10.2, 59.5), 44.1% (27.0, 63.5) and 27.7% (20.2, 35.6) for vaccine-preventable, acute and chronic ACSCs, respectively. However, admissions for ACSCs did not change significantly 30 days after the earthquakes.ConclusionThe 2016 Kumamoto earthquakes were associated with increased hospital admissions for ACSCs. The impact of the earthquakes on admissions for ACSCs did not persist for more than 7 days.

Emergency admissions of ambulatory care sensitive conditions at a Japanese local hospital: An observational study

“…In our study, chronic ACSCs are the largest category among all ACSCs, followed by acute ACSCs and then VP‐ACSCs. These findings are consistent with two studies in Japanese 9,10 and one study abroad 4 but not consistent with one study 11 . It may be because population of Kaneko's study 11 is limited to the elderly.…”

“…(a) This is the first and the largest study in Japan with detailed breakdown of each ASCS category and diagnosis. There are two studies with larger numbers than ours 9,10 but with no detailed breakdown of diagnosis, and there is one study with detailed breakdown 11 but only 38 ACSC admissions. (b) This is the very first study in Japan providing the data on the proportion of ACSCs out of entire admissions or emergency admissions.…”

“…(b) This is the very first study in Japan providing the data on the proportion of ACSCs out of entire admissions or emergency admissions. None of three previous studies [9][10][11] provides such data. (c) This is the first study in Japan including the age younger than 20.…”

“…(c) This is the first study in Japan including the age younger than 20. Two studies include 20 years old and older, 9,10 and one includes only 65 years or older 11 . (d) This is the only study using Bardsley's ASCS definition 4 .…”

“…8 In any case, ACSCs are one of the hot topics within primary care research and many papers are published related to this topic. [1][2][3][4][5][6][7][8][9][10][11][12] However, there are still few reports on ACSCs in Japan [9][10][11] and they are ones in special situation (an effect of earthquake), 9,10 one on rural islands and with few admissions (38 ACSC admissions) 11 and just a case report. 12 No data exist on the city in the usual state against which anyone can use as a benchmarking indicator.…”