Medical Reimbursement Receipt Analysis to Determine the Relationship between Disease Type and Patients' Healthcare-seeking Behavior

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Background: This study aimed to evaluate the relationship between disease type and healthcare-seeking behavior in patients in order to assess the role of primary care in rural areas of Japan.Methods: National Health Insurance receipt data were collected for outpatients from four towns in Hokkaido, Japan. Disease names were encoded using the International Classification of Primary Care-2 (ICPC-2) coding system. Patient data were divided into two categories: those visiting medical facilities in their own towns and those visiting medical facilities in other towns.Results: The percentage of patients who visited medical facilities outside their own town ranged from 42.9% to 72.7%; the mean value for all four towns was 54.6%. The three most frequent ICPC-2 codes according to the reimbursement receipts were K86 (hypertension, uncomplicated), T93 (lipid disorder), and T90 (diabetes, noninsulin dependent), and patients with T90 visited facilities in other towns more than those with K86 and T93. Patients with diseases of the eye, such as F91 (refractive error), F92 (cataract), and F71 (allergic conjunctivitis), and those with psychological disorders, such as P76 (depressive disorder), tended to visit facilities outside their towns rather than in their own towns.Conclusions: Data regarding patients who visit medical facilities in their own towns may provide information on the role of primary care in that particular town. The analysis of medical reimbursement receipts from a particular area provides useful information about disease distribution in addition to an overview of the healthcare needs of the entire community in that area.
一般社団法人日本プライマリ・ケア連合学会の論文

Medical Reimbursement Receipt Analysis to Determine the Relationship between Disease Type and Patients' Healthcare-seeking Behavior

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