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Sakai K, Igarashi Y, Tounai S, Shirai C, Tsurugi Y, Kakuno F, Komasa Y, Fujimura M, Uruha M, Mori K, Tateishi S. Key issues in Japan's public health centers to prepare for future pandemics: a text mining study using a topic model. BMC Health Serv Res 2024; 24:636. [PMID: 38760814 PMCID: PMC11100133 DOI: 10.1186/s12913-024-11094-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 05/08/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND In Japan, over 450 public health centers played a central role in the operation of the local public health system in response to the COVID-19 pandemic. This study aimed to identify key issues for improving the system for public health centers for future pandemics. METHODS We conducted a cross-sectional study using an online questionnaire. The respondents were first line workers in public health centers or local governments during the pandemic. We solicited open-ended responses concerning improvements needed for future pandemics. Issues were identified from these descriptions using morphological analysis and a topic model with KHcoder3.0. The number of topics was estimated using Perplexity as a measure, and Latent Dirichlet Allocation for meaning identification. RESULTS We received open-ended responses from 784 (48.6%) of the 1,612 survey respondents, which included 111 physicians, 330 nurses, and 172 administrative staff. Morphological analysis processed these descriptions into 36,632 words. The topic model summarized them into eight issues: 1) establishment of a crisis management system, 2) division of functions among public health centers, prefectures, and medical institutions, 3) clear role distribution in public health center staff, 4) training of specialists, 5) information sharing system (information about infectious diseases and government policies), 6) response to excessive workload (support from other local governments, cooperation within public health centers, and outsourcing), 7) streamlining operations, and 8) balance with regular duties. CONCLUSIONS This study identified key issues that need to be addressed to prepare Japan's public health centers for future pandemics. These findings are vital for discussions aimed at strengthening the public health system based on experiences from the COVID-19 pandemic.
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Affiliation(s)
- Kosuke Sakai
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu-Shi, Fukuoka-Ken, 807-8555, Japan
| | - Yu Igarashi
- Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu-Shi, Fukuoka-Ken, 807-8555, Japan.
| | - Shuji Tounai
- Oita Prefecture Welfare and Public Health Department, Otemachi, Oita-shi, Oita-ken, 870-0022, Japan
| | - Chika Shirai
- Hirakata City Public Health Center, 2-2-2 Ogaitocho, Hirakata-shi, Osaka-fu, 573-0027, Japan
| | - Yoko Tsurugi
- Kikuchi Public Health Center, Kumamoto, 1272-10 Waifu, Kikuchi-shi, Kumamoto-ken, 861-1331, Japan
| | - Fumihiko Kakuno
- Shiga prefecture Department of Public Health and Medical Welfare, 4-1-1 Kyomachi, Otsu-Shi, Shiga-Ken, 520-8577, Japan
| | - Yukako Komasa
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo-to, 113-0033, Japan
| | - Maya Fujimura
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo-to, 113-0033, Japan
| | - Mika Uruha
- School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu-shi, Fukuoka-ken, 807-8555, Japan
| | - Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu-Shi, Fukuoka-Ken, 807-8555, Japan
| | - Seiichiro Tateishi
- Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu-Shi, Fukuoka-Ken, 807-8555, Japan
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Affiliation(s)
- Colin Binns
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Wah Yun Low
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Asia-Europe Institute, University of Malaya, Kuala Lumpur, Malaysia
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