Tetsuya Otsubo

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BACKGROUND The shortage of physicians in Japan is a serious concern, particularly in specialties like pediatrics. The purpose of this study was to investigate recent changes in the geographic distribution of pediatricians and the factors underlying this change. METHODS We investigated the numerical changes in the pediatrician workforce (2002 to 2007) per(More)
BACKGROUND Acute heart failure (AHF) with its high in-hospital mortality is an increasing burden on healthcare systems worldwide, and comparing hospital performance is required for improving hospital management efficiency. However, it is difficult to distinguish patient severity from individual hospital care effects. The aim of this study was to develop a(More)
BACKGROUND End-of-life (EOL) care imposes heavy economic burdens on patients and health insurers. Little is known about the association between the types of EOL care and healthcare costs for cancer patients across various providers. OBJECTIVE To explore the association of healthcare expenditures with benchmarking indicators of aggressive versus palliative(More)
Long-term survival rates of cancer patients represent important information for policymakers and providers, but analyses from voluntary cancer registries in Japan may not reflect the overall situation. In 2003, the Diagnosis Procedure Combination Per-Diem Payment System (DPC/PDPS) for hospital reimbursement was introduced in Japan; more than half of Japan's(More)
BACKGROUND The economic consequences of environmental tobacco smoke (ETS) have been simulated using models. We examined the individual-level association between ETS exposure and medical costs among Japanese nonsmoking women. METHODS This population-based cohort study enrolled women aged 40 to 79 years living in a rural community. ETS exposure in homes at(More)
BACKGROUND Intravenous tissue plasminogen activator (tPA) is an effective treatment for acute ischemic stroke if administered within a few hours of stroke onset. Because of this time restriction, tPA administration remains infrequent. Ambulance use is an effective strategy for increasing tPA administration but may be influenced by geographical factors. The(More)
OBJECTIVES The objective of this study was to longitudinally examine the geographic distribution of physicians in Japan with adjustment for healthcare demand according to changes in population age structure. METHODS We examined trends in the number of physicians per 100 000 population in Japan's secondary medical areas (SMAs) from 2000 to 2014. Healthcare(More)
To investigate the associations between dementia, the use of long-term care (LTC) services, and the deterioration of care-needs levels of elderly persons in Japan. Using a retrospective cohort study, we analyzed 50,268 insurance beneficiaries aged 65 years and older who had utilized LTC services between 2010 and 2011 in Kyoto prefecture, Japan. Logistic(More)
OBJECTIVES Despite the increasing burden of acute heart failure (AHF) on healthcare systems, the association between centralised cardiovascular specialist care and the quality of AHF care remains unknown. We examine the relationship between the number of cardiologists per hospital and hospital practice variations. DESIGN, SETTING AND PARTICIPANTS In a(More)
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