Analysis of regional disparities in vascular access occlusion treatment in hemodialysis patients using NDB Open Data Japan and GIS

Abstract

　This study examined regional disparities in secondary medical areas for hemodialysis (HD) and endovascular surgery (EVS) for vascular access occlusion (VAO) among patients with end-stage renal disease in Japan using two types of open data: the National Database of Health Insurance Claims and Specific Health Checkups of Japan Open Data and the geographic information system. Analysis of secondary medical areas revealed a weak positive correlation for thrombectomy, while no spatial autocorrelation was observed for other procedures. Principal component and K-means clustering analyses categorized the regions into four distinct groups. The implementation of HD was consistent across clusters, whereas regional differences were observed in advanced treatments, including nocturnal dialysis and EVS-VAO. Notably, the cluster with the highest aging rate showed the lowest EVS-VAO implementation rate. These findings indicate regional disparities in the provision of advanced dialysis treatments and EVS-VAO, despite the consistency of basic HD services. The results suggest potential variations in the provision of comprehensive care for dialysis patients across different regions.