Abstract
The regional medical plan sets the maximum number of hospital bed, and the uniform calculation formula is used nationwide for each secondary medical area reflecting the gender and age group population, the bed utilization rate, etc. It does not consider the difference in function of hospitals. In addition, when inpatients come from outside the prefecture, the number of maximum beds may become lower than the actual required number of beds. The purpose of this study is to clarify that there is a difference in the inflow rate of inpatients from outside the secondary medical area depending on the type of hospitals.
Using the “Patient Survey” in 2017 and the “Medical Facility Survey” in 2017, the inflow rate of hospitalized patients from outside the secondary medical area was compared between the academic medical centers (specially designed hospitals and university teaching hospitals) and the other acute care hospitals. Kruskal-Wallis test was used for significant difference at a significant level of 5%, and multiple comparisons were performed using the Dunn test. Based on an analysis of 3,551 acute care hospitals, the proportion of inpatients from outside the secondary medical area in the academic medical centers was 47.5%, which was significantly higher than the other acute care hospitals. In academic medical centers with highly specialized medical functions, many patients are hospitalized from outside the secondary medical area, and significant part of the beds is used for patients who are not inhabitants of that secondary medical area. Therefore, in secondary medical areas with academic medical centers, there is a possibility that access to inpatient care for local residents may be hindered, and the way to handle the academic medical center should be considered in calculating the maximum number of beds.
