Worsening Health Status among Evacuees: Analysis of Medical Expenditures after the 2011 Great East Japan Earthquake and Nuclear Disaster in Fukushima
Worsening Health Status among Evacuees: Analysis of Medical Expenditures after the 2011 Great East Japan Earthquake and Nuclear Disaster in Fukushima
复制标题
DOI：
10.1620/tjem.248.115
复制
发表时间：
2019-06-01
影响因子：
2.2
通讯作者：
Tsubokura, Masaharu
中科院分区：
文献类型：
--
作者：
Hasegawa, Makoto;Murakami, Michio;Tsubokura, Masaharu
2011年福岛灾难后，该地区居民的健康状况恶化。我们使用医疗保健支出（针对年龄 < 75 岁的自营职业者和失业者）和长期护理支出（主要针对年龄 >= 65 岁的个人）分析了撤离者和非撤离者的健康状况、护理需求和获得医疗服务的情况。福岛县根据避难状况分为四个区域：非EOA（不包括避难令区域（EOA）的市町村）； EOA/非 EOA（同时包括 EOA 和非 EOA 的城市）；短期 EOA（到 2011 财年 (FY) 大部分地区取消了 EOA 指定的城市）；和长期 EOA（大多数 EOA 指定一直保留到 2015 财年年底的城市）。 2015 财年短期和长期 EOA 中人均医疗保健和长期护理支出的增幅高于 2008-2010 财年的平均值。短期和长期 EOA 的支出增幅高于非 EOA 和 EOA/非 EOA。牙科保健支出的增加归因于牙科保健设施的可及性提高。此外，疏散导致医疗保健和长期护理支出的增加，与老龄化无关，并改善了医疗设施的可及性。这些增加的可能解释包括疏散后疏散人员的健康状况不佳、家庭成员和邻居提供的非正式护理的可用性减少以及患者自付费用减少。研究结果强调了疏散人员健康促进的必要性。
After Fukushima disaster in 2011, the health status of the region's residents deteriorated. We analyzed the health status, care needs, and access to health services among evacuees and non-evacuees using healthcare expenditure (for self-employed and unemployed individuals aged < 75 years) and long-term care expenditure (mainly for individuals aged >= 65 years). Fukushima Prefecture was divided into four areas according to their evacuation status: non-EOAs (municipalities that did not include evacuation order areas (EOAs)); EOAs/non-EOAs (municipalities that included both EOAs and non-EOAs); short-term EOAs (municipalities where the EOA designation was lifted in most areas by fiscal year (FY) 2011); and long-term EOAs (municipalities where most EOA designations remained in place until the end of FY 2015). Increases in expenditure on healthcare and long-term care per capita in short-term and long-term EOAs were greater in FY 2015 than the average values in FYs 2008-2010. The increases in expenditure were higher in short-term and long-term EOAs than those in non-EOAs and EOAs/non-EOAs. The increases in dental health expenditure were attributed to enhanced accessibility to dental health facilities. Furthermore, the evacuations contributed to increases in healthcare and long-term care expenditure, independent of aging and improved accessibly to health facilities. Possible explanations for these increases include the poor health status of the evacuees following the evacuations, reduced availability of informal care provided by family members and neighbors, and reduced patient copayments. The findings highlight the necessity of health promotion among evacuees.