Regional Variations in Access to Healthcare among Japanese Individuals over 50 Years Old: An analysis using JSTAR (Japanese)

Studies have repeatedly reported regional variations in health conditions within a country, but the reason behind such disparities is still under debate. In this study, among the contributors to health disparities, we focus on healthcare-seeking behavior. We examine how regional characteristics affect such behavior of individuals over 50 years old regarding screening and controlling common chronic conditions such as hypertension, hypercholesterolemia, and diabetes. Our analysis using the Japanese Study of Aging and Retirement (JSTAR) shows that there are differences of at least three to 10 percentage points in the proportion of those who seek care across 10 areas covered. On applying a multilevel regression framework, we find that the vast majorities of these differences are due to composition effects, namely, the difference in the distribution of health risk at the individual level. We also find that regional characteristics do not play a major role in explaining the difference in healthcare-seeking activities. However, the concentration of healthcare resources in a region is found to be correlated with the decision to seek healthcare for certain chronic conditions, suggesting that the role of healthcare resources could differ by chronic condition.