key: cord-0730210-zdlc8cot
authors: Aoki, Takuya; Matsushima, Masato
title: Response to Letter to the Editor: Ecology of Medical Care
date: 2022-05-13
journal: J Gen Intern Med
DOI: 10.1007/s11606-022-07656-5
sha: ebe0053d93e5d6ee23b7228beb5001dbcacc5b4e
doc_id: 730210
cord_uid: zdlc8cot

nan

W e wish to express our appreciation to Drs. Shibata, Kanaoka, and Banno for their insightful comments on our paper entitled "The Ecology of Medical Care During the COVID-19 Pandemic in Japan: a Nationwide Survey." 1 We understand their concern about the participant selection. In this study, we have selected participants aged 20-75 years for feasibility; therefore, we might have underestimated the use of home care which is mainly for the elderly.

As noted by Shibata et al., in Japan, longer intervals between outpatient visits have been reported in recent years. However, these findings are, of course, based on studies of returning patients and are unlikely to have influenced the results of our study which investigated health-care utilization for new health-related events. 2 In the elderly group, our study showed lower frequency of home health-care use for health-related events than those in the 2013 study. 3 In addition, in both non-elderly and elderly groups, complementary or alternative medicine (CAM) use also decreased remarkably. The cause of these changes may also be an increase in the threshold for health-care utilization due to fear of being infected by COVID-19. 

Letter to the editor: Ecology of medical care

The ecology of medical care during the COVID-19 pandemic in Japan: a nationwide survey

Reassessing the ecology of medical care in Japan