Reassessing the Ecology of Medical Care in Japan

Abstract

Studies on ecology of medical care can provide valuable information on how people seek healthcare in a specific geographic area. The objective of this study was to update a 2003 report on the ecology of medical care in Japan, identifying relevant changes in healthcare patterns. We collected information based on a prospective health diary recorded for a month in 2013 (n = 4548; 3787 adults and 797 children) using a population-weighted random sample from a nationally representative panel. We compared our overall and stratified findings with a similar study conducted in 2003. During a one-month period, per 1000 adults and children living in Japan, we estimated that 794 report at least one symptom, 447 use an over-the-counter (OTC) drug, 265 visit a physician's office, 117 seek help from a professional provider of complementary or alternative medicine (CAM), 70 visit a hospital outpatient clinic (60 community-based and 10 university-based), 6 are hospitalized, and 4 visit a hospital emergency department. After adjusting for demographic variables, we found that healthcare seeking behaviors were influenced by age, gender and area of living. Compared with the 2003 study, participants in this study had fewer symptoms, fewer physician and emergency room visits, and less OTC use, but reported higher frequency of CAM use (p < .01 for all). Compared with 2003, reported symptoms, physician visits and OTC use has decreased, while CAM use has increased. Our findings may be useful to policymakers in Japan in a context where healthcare expenditure and a rapidly aging population are two challenging issues.

Building primary care in Japan: Literature review

“…The ecology of medical care in Japan has been investigated. Among 4548 national‐representative participants, during a one month period, per 1000 inhabitants, 794 people report at least one symptom, 447 used an over‐the‐counter drug, 265 visited a physician's office, 70 visited a hospital outpatient clinic (60 community‐based and 10 university‐based), 6 were hospitalized, and 4 visited a hospital emergency department . The results were similar to other East Asian countries …”

Weather and Health Symptoms

“…First, individuals were blinded to the research question by the nature of the study, and thus there was no differential information bias in reporting symptoms. In the original study [13], the participants recorded their symptoms and the type of action taken in response to the symptom. Their mindset was focused on symptoms and health care seeking behaviors, and not weather patterns.…”

“…Fukui et al [13] reported on the ecology of medical care in Japan and evaluated the relationship between health symptoms and patterns of health care utilization. In their study, they used a survey company that maintained a roster of 79,749 individuals (37,643 men and 42,106 women).…”

“…The Health Diary Study [13] conducted in Japan in October 2013, has the ability to address this research question while overcoming several of the limitations of previous studies. The original purpose of the study was to evaluate the health care seeking behaviors for different types of ailments and physical/mental symptoms.…”

Development of Primary Care, Lifestyle Disease and New ElderlyAssociation (NEA) in Japan – Common Philosophy With Hinohara-ism

“…Currently, PC have been indispensable medicine in Japan for its ecological predominance [7,8]. Thus, it was Dr. Hinohara that introduced and developed PC in Japan, indicating that he would be the Father of Primary Care in Japan.…”