Abstract
The present study was conducted to analyze the relationship between the changes in the local distribution of general medical clinics and gaps in the access to home-based medical care from 1995 to 2012. The results revealed the following 4 important findings. （1） Access to medical care at medical clinics has been clearly improving over the past 18 years. （2） As for home-based medical care, a significant gap in access was observed, especially in access to home care supporting clinics. （3） The distribution of home care supporting clinics tended to be denser in Western Japan than in Eastern Japan, with a 5-fold difference between the two regions. （4） The locally uneven distribution of home care supporting clinics tended to be higher in areas with a higher density of medical institutions due to the formation of industrial clusters in the area. （5） Higher fees for medical services provided by home care supporting clinics may promote locally uneven distribution. Therefore, the results suggested the necessity of establishing a comprehensive support system for home-based medical care according to the actual situation in each area, in addition to a national project for developing a uniform system throughout the country for the distribution of home care supporting clinics.
