{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:59:15Z","timestamp":1790405955771,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gen and Family Med"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Japan will reach peak population aging around 2043. To better understand healthcare\u2010seeking behaviors in depopulated and aging communities, we examined healthcare utilization patterns in rural areas of Japan throughout 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Ecology of Medical Care model, we conducted a descriptive study in a mountainous area of Japan. Health behaviors were summarized per 1000 population with 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1285 residents reported 2021 health problems. The median age was 63\u2009years (interquartile range, 39\u201374\u2009years), and 47.2% of respondents were aged \u2265\u200965\u2009years. Per 1000 population (95% CI), the estimated numbers of individuals were: no symptoms, 782 (759\u2013805); observation, 20 (13\u201328); self\u2010care without medical consultation, 34 (24\u201343); clinic visits, 42 (31\u201353); primary hospital visits, 52 (40\u201364); secondary hospital visits, 31 (22\u201340); tertiary hospital visits, 8 (3\u201313); ambulance transport, 2 (0\u20135); hospitalization, 27 (18\u201336); and urgent home visits 2 (0\u20135). Self\u2010care without medical consultation among young adults as well as hospitalizations and ambulance transports among those aged \u2265\u200975\u2009years were more frequent; children often used higher\u2010level hospital services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In rural mountainous communities, younger adults were more likely to rely on self\u2010care, whereas older adults had higher rates of hospitalization, and children used centralized hospitals more frequently. These findings provide insight into healthcare\u2010seeking patterns in communities experiencing population aging and decline.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgf2.70169","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T09:46:28Z","timestamp":1787132788000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare\u2010Seeking Behaviors in a Depopulated Rural Area of Shiga Prefecture, Japan in 2025: A Descriptive Study Using the Ecology of Medical Care Model"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3833-4044","authenticated-orcid":false,"given":"Yoshio","family":"Hisata","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Nagahama City Kohoku Hospital  Nagahama Japan"},{"name":"Department of General Medicine Saga University Hospital  Saga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakiya","family":"Nishida","sequence":"additional","affiliation":[{"name":"Department of General Medicine Koka City Shigaraki Central Hospital  Koka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7897-5252","authenticated-orcid":false,"given":"Risa H.","family":"Yoshinaga","sequence":"additional","affiliation":[{"name":"Department of General Medicine Saga University Hospital  Saga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9599-5287","authenticated-orcid":false,"given":"Naoko E.","family":"Katsuki","sequence":"additional","affiliation":[{"name":"Department of General Medicine Saga University Hospital  Saga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1092-1834","authenticated-orcid":false,"given":"Masaki","family":"Tago","sequence":"additional","affiliation":[{"name":"Department of General Medicine Saga University Hospital  Saga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Nishiazai Clinic  Nagahama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Sugioka","sequence":"additional","affiliation":[{"name":"Department of General Medicine Saga City Fuji\u2010Yamato Spa. Hospital  Saga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Amenomori","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Shiga Center for Family Medicine  Gamo\u2010gun Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsumi","family":"Higashino","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Nagahama City Kohoku Hospital  Nagahama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1290-5152","authenticated-orcid":false,"given":"Yoshio","family":"Naya","sequence":"additional","affiliation":[{"name":"Department of Urology Nagahama City Kohoku Hospital  Nagahama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"United Nations. 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