Abstract
The city of Itoigawa is a remote place, with a population of as few as 50,000, where people aged 65 and older occupy 30% of its population. Most people with neurological disorders here have been treated at the Neurosurgical Department of the Itoigawa General Hospital. However, the number of surgical operations has decreased year after year. In search of the factors in the decreasing tendency, we analized the annual statistics about the hospitalized patients and this city's population in the past 11 years beginning on Nov. 1 1995. The diminution of the operation cases was correlated most positively with a decrease in the population of this city (+0.844), and most negatively with an increase in the ratio of persons aged 65 or older (-0.822). The number of operation cases was probably linked to the change in population make-up of the region. The number of operations on older patients had a tendency to decline presumably because of functionally poor prognosis. Conclusively, this study revealed that it is hard for neurosurgeons working in remote localities like this city to keep up the number of operative cases.
