title: High-tech rural clinics and hospitals in Japan: a comparison to the Japanese average.
abstract: BACKGROUND
  Japanese medical facilities are noted for being heavily equipped with high-tech equipment compared to other industrialised countries. Rural facilities are anecdotally said to be better equipped than facilities in other areas due to egalitarian health resource diffusion policies by public sectors whose goal is to secure fair access to modern medical technologies among the entire population.
  
  
  OBJECTIVE
  To show the technology status of rural practice and compare it to the national level.
  
  
  METHODS
  Nationwide postal survey.
  
  
  METHODS
  Questionnaires were sent to the directors of 1362 public hospitals and clinics (of the 1723 municipalities defined as 'rural' by four national laws). Information was collected about the technologies they possessed. The data were compared with figures from a national census of all hospitals and clinics.
  
  
  RESULTS
  A total of 766 facilities responded (an effective response rate of 56%). Rural facilities showed higher possession rates in most comparable technologies than the national level. It is noted that almost all rural hospitals had gastroscopes and colonoscopes and their possession rates of bronchoscopes and dialysis equipment were twice as high as the national level. The discrepancy in possession rates between rural and national was even more remarkable in clinics than in hospitals. Rural clinics owned twice as many abdominal ultrasonographs, and three times as many gastroscopes, colonoscopes, defibrillators and computed tomography scanners as the national level.
  
  
  CONCLUSIONS
  Rural facilities are equipped with more technology than urban ones. Government-led, tax based, technology diffusion in the entire country seems to have attained its goal. What is already known on this subject: As a general tendency in both developing and developed countries, rural medical facilities are technologically less equipped than their urban counterparts. What does this paper add?: In Japan, rural medical facilities are technologically better equipped than urban facilities.
authors.affiliation: Department of Community and Family Medicine, Jichi Medical School, Tochigi 329-0498, Japan. matomo10@jb3.so-net.ne.jp
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Masanobu
authors.initials: M
authors.lastname: Okayama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Inoue
authors.forename: Eiji
authors.initials: E
authors.lastname: Kajii
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D003362:Cost-Benefit Analysis; D004059:Diffusion of Innovation; D017598:Efficiency, Organizational; D005380:Financing, Government / Q000458:organization & administration; D006302:Health Services Research; D006779:Hospitals, Public / Q000458:organization & administration*; D006780:Hospitals, Rural / Q000458:organization & administration*; D006786:Hospitals, Urban / Q000458:organization & administration; D007564:Japan; D008507:Medically Underserved Area; D020380:Needs Assessment; D011795:Surveys and Questionnaires; D013675:Technology, High-Cost / Q000458:organization & administration*