[Geographical distribution of medical expenditure for the aged insured by National Health Insurance in secondary medical care areas in Japan].
OBJECTIVE
To determine what factors affect medical expenditure for the aged insured by the National Health Insurance among secondary medical care areas.


METHODS
The original data of municipalities were combined and converted into the data of secondary medical areas. The original data included medical expenditure of the aged in 1994, medical supply factors per 100,000 population (numbers of doctors, numbers of general beds in hospitals, numbers of clinics, etc.) and socio-economic factors (income, proportion of employees for three sectors of industries, population density, average size of family, etc.). Medical expenditures for inpatients and outpatients were used separately as independent variables. The medical supply and socio-economic factors have been used as dependent variables. Multiple regression models were applied to clarify the differences in the contributing factors between inpatient and outpatient.


RESULTS
1. The maximum inpatient and outpatient medical expenditures for the aged are respectively 4 times and 2.6 times more expensive than minimum expenditures among secondary medical care areas. 2. The numbers of beds, income per capita, numbers of doctor, average size of family, proportion of employees for third level industry and income accounted for 57.4% of variance in inpatient medical expenditure of the aged. 3. The proportion of employees for first level industry, the numbers of beds and average members of family accounted for 21.4% of variance in outpatient medical expenditure of the aged. 4. Medical expenditure for inpatients related with medical supply and socioeconomic factors differently from that of outpatients.
Department of Public Health, Jichi Medical School.
T
T
Zhang
S
S
Tanihara
H
H
Yanagawa
D000368:Aged; D002391:Catchment Area, Health; D003695:Delivery of Health Care; D005102:Health Expenditures; D006299:Health Services for the Aged / Q000191:economics*; D006801:Humans; D007297:Inpatients; D007564:Japan; D009313:National Health Programs; D010045:Outpatients; D012044:Regression Analysis; D012959:Socioeconomic Factors