Trends in cardiovascular care in Japan from 2010 to 2019 in relation to population density

Abstract

Abstract Background As Japan faces a declining birthrate and an ageing population, it is also necessary to transfer the population from urban areas to rural areas to prevent depopulation in rural areas. On the other hand, it is necessary to verify whether cardiovascular medical care systems are equalized regardless of population density. Purpose The aim of this study is to describe the evolution of healthcare in Japan by population density. Methods This descriptive study used data obtained from the Japanese Registry of All Cardiac and Vascular Diseases database from 2010 to 2019. The nationwide 10-year trend in cardiovascular medical care systems was described in total and according to quartiles of hospitals based on population density. Results The number of patients admitted to cardiovascular facilities and the number of cardiologists showed a 1.26-fold and 1.18-fold increase from 2010 to 2019, respectively (P for trend <0.01 for both). The very high population density category had a lower number of hospitals and cardiology beds per population, whereas the very low population density category had a lower number of cardiologists per population. A greater increase in the number of patients was observed in the higher population density category (P for interaction<0.01). The difference in the number of hospitalized patients per cardiologist decreased among the population density categories. Conclusion Based on population density, the highest increase in the number of patients and cardiologists per hospital was observed in the higher population density category; however, the difference in the number of patients per cardiologist decreased among the categories. Figure legend Hospital-level trends in cardiovascular medical care systems according to population density. (A, B, and C) The number of patients to cardiologists according to population density. (D)