広島市を中心とする外来患者の流動と受療先決定要因

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Up to this time, the distance has been used as an index for the study of optimal location with the linear programming method. It is known, however, that the patients decide the destination where they receive medical care by considering other factors(indicies) too. In this study the author tried to make these factors clear using multi regression analysis as a case study of outpatient behavior in Hiroshima prefecture. In this analysis, the value, which is the ratio of outpatients utilizing the medical facilities in Hiroshima city to all patients of the community, is accepted as the dependent variable. As a result the distance(X*) occured as the most important factor, as before estimated. Other factors in order of importance are the intervening opportunity(X+)(the ratio of patients utilizing the modical facilities in the large cities except Hiroshima city to all patients of the community), the ratio of workers employed in the primary industry to all workers of the community(X6), the ratio of patients with disturbances of the circulatory organs to all patients of the community (X7), and the ratio of patients serviced by the facility within their OWn community to all patients of the community(X3)' These five independent variables explain 69.2% of the variation of the dependent variable.The distribution of residuals seems to still be significant, for it shows positive value in the west part of Hiroshima prefecture but negative value in the east part. The fact that the distance is the most important factor may strongly support the standpoint of the study of optimal location. However, the author cannot accept this stand entirely, because the intervening opportunity as the second factor cannot be negligible, and there may be other factors concerning the outpatient behavior according to the distribution of residuals. In order to make a better index for the study of optimal location, we may need to weigh the index(based on the distance) with those factors, especially the intervening opportunity. We should, however, apply this index to the patient groups classified by disease or particular department of medicine rather than to all patients unclassified. Simultaneously we should find a general factor of determining outpatient behavior, not only of Hiroshima city, but also of other cities. The author hopes to advance his study by using such a method in future.
地理科学学会の論文

広島市を中心とする外来患者の流動と受療先決定要因

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