Analysis of Disease Structure for the Regional Health Care Plan Based on the National Database

Abstract

In Japan, Regional Health Care Plan (RHCP) is established every 5 years that defines health care region, regulates the health resources and intends to coordinate the health services. It requires the concrete data for actual and future situation. In order to ameliorate the quality of RHCP, we have tried to describe the actual situation of health service delivery for cerebral infarction in Fukuoka prefecture, based on the nationally accumulated claim database, so called National Database (NDB). For this analysis, we have used the one month data (October, 2010) of Fukuoka prefecture. This dataset contains the about 1,500,000 claim data. The ID number was hashed twice in order to make it anonymous. Using this dataset, we have conducted in- and out-flow analyses of the cerebral infarction patients for each of 13 HCRs of Fukuoka. In the case of acute in-patient care, six HCRs (Fukuoka-Itoshima, Nogata-Kurate, Kitakyushu, Chikushi, Yame-Chikugo and Ariake) showed more than 80% self-completion rate, that is, more than 80% of patient who live in these areas receive the acute in-hospital services at the hospital of their residential areas. On the other hand, sub-acute care beds were in shortage in some HCR such as Iizuka. The present study has clarified the usefulness of NDB for describing the disease structure of each HCR. Using this kind of information, policy makers can formulate a more practical health care plan.