A research group led by Atsushi Kaneko, a lecturer at the Graduate School of Data Science, Yokohama City University, conducted the first survey in Japan on the division of care for elderly people who visit multiple medical institutions in addition to their family doctor, using a database in Yokohama City. , 26.1% had a care division index of 0.7 or higher, which is considered to be a high level of care.
According to Yokohama City University, the survey was conducted between April 2018 and March 4 for those who have a Yokohama City resident card and who are 2019 years of age or older and who are members of the Latter-Stage Medical Care Interjurisdictional Union or public assistance recipients. The target is 3 people who have used medical institutions more than once.The research group calculated the index of care from the total annual number of consultations recorded in the receipt (medical fee statement) data, the number of medical institutions visited, and the number of visits to each medical institution.
As a result, the average number of medical institutions visited per year was 3.42, with a maximum of 20.Eighty-five percent of the population visited two or more medical institutions, and 85 percent of the elderly had a care fragmentation index of 2 or higher.The care fragmentation index is expressed as a number between 0.7 and 26.1, with 0 being the highest number.Past research has revealed that the degree of fragmentation is high when the value is 1 or higher.
Continuity of care is known to reduce ambulances, hospitalizations, and deaths when people continue to receive medical care from a single doctor or facility.In contrast, high care fragmentation is associated with excessive medical care, ambulance transport, and hospitalization.
Paper information:[BMJ Open] Fragmentation of Ambulatory Care among Older Adults: an Exhaustive Database Study in an Aging City in Japan
