Analyzing Catchment Areas for Home Medical Care Services Using Real-world Claims Data

Background When evaluating the supply-demand balance of home medical care services (HMCS), it is important to consider catchment areas, as the distance to patients may influence healthcare providers’ behavior. This study aims to examine analytical methods using a medical claims database to identify catchment areas for HMCS, to better assess their supply-demand balance. Methods The subjects were 39 municipalities in Nara prefecture, Japan, as a model case. The information on patients and hospitals or clinics was obtained from medical claims in the prefecture-wide (KDB) database in FY 2019. The travel distances from hospitals or clinics to patients were analyzed using a geographical information system (GIS) for three categories of HMCS: (1) cases where the Home Medical Care Management Fee (HMCMF) was charged, (2) cases where the Facility Admission Medical Care Management Fee (FAMCMF) was charged, and (3) all other cases. The catchment areas were aggregated for three groups based on population density, from both the facility and patient perspectives. In addition, utilization rates and the number of hospitals or clinics providing HMCS were also aggregated. Results The number of facilities for HMCMF and FAMCMF was limited, and the utilization rates for these services were lower in sparsely populated municipalities such as Nanwa in the southern part. From the facility perspective, the catchment areas were 3.4, 3.1, and 2.1 km for HMCMF, 8.9, 7.6, and 4.3 km for FAMCMF, and 3.8, 2.5, and 2.8 km for the other category in the low, middle, and high population density groups, respectively. Conclusions The catchment areas for HMCS were analyzed using the KDB database and GIS. In Nara Prefecture, the catchment areas were broader for FAMCMF than for the other categories. The catchment areas did not differ much between the population density groups from the facility perspective. The results also indicate that, particularly for HMCMF and FAMCMF, the needs in some sparsely populated municipalities may not be adequately met.