Regional Disparities in Atrial Fibrillation Catheter Ablation Based on the Japanese National Survey

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  Figure 1.. (A) Research question. The objective of this study was to determine if patients in Japan, a country with a universal healthcare system, have equitable access to catheter ablation procedures. This study also determined if healthcare disparities can occur in countries with universal health insurance systems like Japan. Japan has a population of approximately 12,947,000 and extends from north to south, resulting in regional differences in climate. Additionally, Japan is known as one of the most rapidly aging societies in the world. Data were analyzed at the prefectural level. The image shown is downloaded from Frame illust (https://frame-illust.com/). The materials distributed on the site may be downloaded and used free of charge by individuals and businesses alike. No prior notice or credit is required; anyone can use the images in commercial print materials, websites, and visual media. (B) Temperature and humidity in Japan. The average temperature, minimum temperature, and annual average humidity for each prefecture in Japan are shown. The background colors of the bars in this graph correspond to the colors in (A).

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  Figure 2.. (A) Atrial fibrillation (AF) hospitalizations are defined as the number of tachycardia hospitalizations using Diagnosis Procedure Combination (DPC) data, corrected for total population. However, the number of AF hospitalizations remains unchanged in both cold and warm weather conditions. (B) The relationship between specialists and ablation procedures. The number of Japanese Heart Rhythm Society-certified arrhythmia specialists and the total AF ablations per specialist in each prefecture are shown.

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  Figure 3.. (A) Elderly population. The heat map shows the elderly population in each prefecture, particularly those aged ≥65 (over 65 y/o), ≥75 (over 75 y/o), and ≥85 (over 85 y/o) years. (B) Income comparison. The incomes of new graduates in each prefecture are shown. ‘Highschool’ indicates high school graduates and ‘University’ indicates university graduates. The data is divided by gender. (C) Standard working hours. The average standard working hours for males and females in each prefecture. (D) Overtime working hours. The average overtime working hours for males and females in each prefecture.

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  Figure 4.. (A) Prevalence of preexisting diseases. The prevalences of various diseases in each prefecture are shown. Hypertension has a significantly higher prevalence compared with other diseases. (B) Smoking and drinking. The percentage of current smokers (Current smoker %), past smokers (Past smoker %), and individuals who drink alcohol >3 times per week (alcohol % [3/week]) in each prefecture. (C) Comparison of sleep duration. The distribution of sleep duration in each prefecture. The percentage of individuals who sleep <5 h per day varies significantly among the prefectures.