title: Status and future needs of regional adult congenital heart disease centers in Japan.
abstract: BACKGROUND
  Although the prevalence of adult congenital heart disease (ACHD) in Japan continues to rise, the number and geographic distribution of facilities potentially serving as regional ACHD centers remains unknown. We examined trends in ACHD care in Japan to identify needs and to determine potential regional responses to this growing patient population.
  
  
  RESULTS
  A descriptive, cross-sectional, nationwide survey was conducted to assess the status and needs of cardiology specialists related to providing ACHD care. Questionnaires were mailed to 138 cardiology departments located in 8 geographical regions throughout Japan; respondents were asked to document the status and future direction of ACHD care for each facility. Of the 109 facilities that responded, approximately one-third currently treat or plan to treat all ACHD patients. Fourteen facilities (12.8%) fulfilled all criteria for becoming regional ACHD centers. Although each regional center was projected to serve a population of 9.1 million, in 2 regions, no centers possessed the necessary care structure.
  
  
  CONCLUSIONS
  Our findings revealed a shortage of adult cardiologists dedicated to ACHD care. Moreover, basic as well as formal fellowship ACHD training was deemed necessary. In Japan, the number of potential regional ACHD centers has just reached international standards. However, based on the geographic gaps documented here, a strategy other than regional centralization might be required to deliver adequate ACHD care to rural areas.
authors: Department of Adult Nursing/Palliative Care Nursing, School of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Ryota
authors: R
authors: Ochiai
authors: Atsushi
authors: A
authors: Yao
authors: Koichiro
authors: K
authors: Kinugawa
authors: Ryozo
authors: R
authors: Nagai
authors: Isao
authors: I
authors: Shiraishi
authors: Koichiro
authors: K
authors: Niwa
mesh_terms: D000328:Adult; D002300:Cardiac Care Facilities / Q000592:standards / Q000600:supply & distribution* / Q000639:trends; D002309:Cardiology / Q000592:standards / Q000639:trends; D004503:Education, Medical, Graduate; D005260:Female; D006330:Heart Defects, Congenital; D006801:Humans; D007564:Japan; D008297:Male; D019035:Rural Health Services / Q000592:standards / Q000600:supply & distribution* / Q000639:trends; D011795:Surveys and Questionnaires