Children's access to major hospitals estimated to provide pediatric inpatient services 24 h a day in Japan.

To measure the geographic accessibility of pediatric inpatient medical services in Japan, the proportion of children who lived within 5, 10, 20, and 30 km of the nearest hospital providing inpatient services for children and staffed by at least five full-time equivalent pediatricians was calculated. Geographic information systems were used to assess the location of the hospitals, and the latitude, longitude, and child population of 219,100 residential "blocks" in Japan. The population and proportion of children in over- and under-populated prefectures were compared to show differences in accessibility.

CONCLUSION: Of the 15.88 million children in Japan, 14.72 million (92.7%) lived within 30 km of the nearest hospital with at least five full-time equivalent pediatricians. They could therefore probably reach it within 1 h by car. However, the proportion of children living further than 30 km away varied across under- and over-populated prefecture groups. More than half of the 1.16 million children who lived in areas more than 30 km from the nearest hospital were in the 12 prefectures with the lowest population densities. Plans for medical provision for children should therefore be formulated differently for over- and under-populated prefectures, with provision made for improved transport from remote areas. What is Known: • The number of pediatricians and hospitals with pediatric departments is surveyed by Japanese health authorities, and the statistics on medical resources in each prefecture are published on the Japanese government's website. • Accessibility of medical services for children has not been well analyzed in Japan. What is New: • In total, 92.7% of Japanese children lived within 30 km of the nearest major hospital providing pediatric inpatient services. • More than half of the remaining children were residents of the 12 prefectures with the lowest population density.