An Ecological Study on Regional Disparity in the Provision of Rehabilitation Services Using Open NDB Data Japan

Background: Although medical resources related to rehabilitation services should be optimally allocated and utilized uniformly and efficiently, there is few reports on regional differences in the supply/demand balance and the provision of these services. This study analyzed the regional differences to help policymakers provide more uniform and efficient rehabilitation services and optimal allocation of related resources. Methods The subjects were 47 prefectures and nine regions in Japan in 2017. Primary indicators were “supply/utilization ratio”, which was calculated by dividing rehabilitation supply converted to service units, by rehabilitation utilized (utilization) and “utilization/needs ratio”, which was calculated by dividing utilization by needs. The needs were defined as utilization expected from the demographic in each area. The utilization/needs ratios were calculated for overall and individual rehabilitation services. Data required to calculate these indicators were collected from open sources such as NDB Open Data Japan. Results The supply/utilization ratios were higher in Shikoku, Kyusyu, Tohoku, and Hokuriku regions, and lower in Kanto and Tokai regions. The number of rehabilitation-related providers per population was larger mostly in the western parts of Japan and lower mostly in the eastern parts. The utilization/needs ratios were higher mostly in the western parts such as Shikoku and Kyusyu regions, and lower mostly in the eastern parts such as Tohoku, and Hokuriku regions. The same trend was seen for utilization/needs ratio of cerebrovascular disease and musculoskeletal disorders rehabilitation, which accounted for approximately 84% of rehabilitation services. For disuse syndrome rehabilitation, such a trend did not exist, and the utilization/needs ratio differed by prefectures. Conclusions The surplus in rehabilitation supply was attributed to the larger number of providers in the western parts and less amount of utilization in the eastern parts, indicating regional differences in the provision of rehabilitation services. Since cerebrovascular disease and musculoskeletal disorder rehabilitation accounted for a large part of services, priority should be given to them when considering an increase in uniform and efficient rehabilitation services.