Impact of the 2011 Great East Japan Earthquake on community health : ecological time series on transient increase in indirect mortality and recovery of health and long-term-care system
Impact of the 2011 Great East Japan Earthquake on community health : ecological time series on transient increase in indirect mortality and recovery of health and long-term-care system
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2011 年东日本大地震对社区健康的影响：间接死亡率短暂增加以及健康和长期护理系统恢复的生态时间序列
DOI：
10.1136/jech-2014-204063
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Seino K
中科院分区：
文献类型：
--
作者：
Uchimura M;Kizuki M;Takano T;Morita A;Seino K
背景目的是阐明2011年东日本大地震后特定原因死亡率的趋势以及健康和长期护理使用的变化。方法我们从国家来源获得了以下数据：按原因、年龄和月份划分的死亡人数；按服务类型、年龄和月份划分的医疗保险支出金额；按服务类型、年龄、护理需求和月份划分的长期护理保险支出金额。我们通过对其他县的趋势进行调整，估计了岩手县、宫城县和福岛县这三个重灾县震后标准化死亡率较震前的上升情况，以及震后健康和长期护理保险支出标准化金额较震前的变化情况。 地震（相对风险 (RR)，60-69 岁年龄组的 95% CI 为 1.20（1.13 至 1.28），70-79 岁年龄组为 1.25（1.17 至 1.32），80 岁及以上年龄组为 1.33（1.27 至 1.38））。地震当月老年人健康和长期护理保险支出金额有所下降，1-5个月内恢复到正常水平的95%。在遭受海啸袭击的城镇中，被淹没的家庭比例越高，间接死亡风险越高（p<0.001），门诊医疗支出较低（p<0.001），家庭护理服务支出较低（p<0.001）。结论本研究显示，地震后间接死亡率以及健康和长期护理系统的恢复出现短暂增加。
BackgroundThe objectives were to clarify the trend in the cause-specific mortality rate and changes in health and long-term-care use after the Great East Japan Earthquake in 2011.MethodsWe obtained the following data from national sources: the number of deaths by cause, age and month; the amount of healthcare insurance expenditures by type of services, age and month; the amount of long-term-care insurance expenditures by type of services, age, care need and month. We estimated increase in standardised mortality rate postearthquake compared with pre-earthquake, and change in the standardised amount of health and long-term-care insurance expenditures post-earthquake compared with pre-earthquake in three severely affected prefectures, Iwate, Miyagi and Fukushima, by the adjustment for trends in the other prefectures.ResultsThe risk of indirect mortality increased in the month of the earthquake (relative risk (RR) with 95% CI 1.20 (1.13 to 1.28) for those 60–69 years of age, 1.25 (1.17 to 1.32) for 70–79 years, and 1.33 (1.27 to 1.38) for 80 years and older). The amount of health and long-term-care insurance expenditures decreased among elderly persons in the month of the earthquake, and recovered to 95% of usual level within 1–5 months. Among cities and towns hit by tsunami, higher percentage of households flooded was associated with higher risk of indirect mortality (p<0.001), lower expenditures for outpatient medical care (p<0.001), and lower expenditures for home-care services (p<0.001).ConclusionsThis study showed transient increase in indirect mortality and recovery of health and long-term-care system after the earthquake.