Journal of Public Health

, Volume 22, Issue 4, pp 361–370 | Cite as

Factors affecting regional variations in hospitalization expenditures of elderly residents in Japan

  • Etsu Goto
  • Jason Lee
  • Noriko Sasaki
  • Yuichi Imanaka
Original Article

Abstract

Aim

The aim of this study was to examine the possible effects of healthcare resource factors, socioeconomic factors, and sociodemographic factors on variations in hospitalization expenditures of elderly patients in Japan at different levels of urbanization.

Subject and methods

A secondary analysis was conducted using data obtained from a regional health care cost report and the Portal Site of Official Statistics of Japan. The regional unit of analysis used was the secondary medical care area. We divided these areas into three groups based on their levels of urbanization (low, middle, and high urbanization), indicated by their respective population densities of inhabitable areas. Multiple linear regression models were used to analyze the candidate factors affecting per capita hospitalization expenditures of elderly residents.

Results

The significance and magnitude of associations were observed to vary according to different levels of urbanization. Our findings showed that medical resource factors and sociodemographic factors were more influential in areas of low urbanization, whereas the number of hospital beds and socioeconomic factors appeared more influential in high urbanization areas.

Conclusion

Policies designed to contain healthcare expenditures should take regional characteristics and levels of urbanization into account in order to support the development and implementation of region-specific improvements that ensure affordable healthcare for the elderly.

Keywords

Demography Health care financing Health disparities Health services for the aged Utilization of health services 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Etsu Goto
    • 1
  • Jason Lee
    • 1
  • Noriko Sasaki
    • 1
  • Yuichi Imanaka
    • 1
  1. 1.Department of Healthcare Economics and Quality Management, Graduate School of MedicineKyoto UniversitySakyo-kuJapan

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