This study clarifies the operational and utilization characteristics of Multifunctional Small-Scale Nursing Facilities (MSNFs) in hilly/mountainous areas (MtA) compared to urban metropolitan areas (Tokyo). MSNFs were classified based on combined facility types and service provision performance, case facilities were examined for operational conditions, and travel distances of registered users were analyzed. Key findings include: 1) Standalone facilities were predominant in MtA (53.2% vs. 35.7% in metropolitan areas), whereas combined facilities in MtA exhibited dispersed annexation patterns across Types II and III (~20% each). 2) Regarding service performance, MtA facilities showed a significantly higher proportion of high-frequency home-visit care (≥ 32 times/month: 9.1% vs. 1.4% in metropolitan areas). 3) Operational case analyses revealed that wide-area shuttle transport with grouped passengers and physical corridor/floor integration with Combined Group Homes (GHs) for smooth post-service residential transitions are critical operational features in MtA. 4) Travel distance analysis demonstrated that 61.9% of registered users in MtA resided >3 km from facilities, compared to only 6.1% in Tokyo (where 51.7% resided ≤1 km). These findings indicate that MSNFs in MtA cover substantially broader geographical service areas and require spatial and operational strategies tailored to sparse, wide-area care delivery compared to urban facilities
목차
Abstract 1. Introduction 1.1 Background and Purpose of Study 1.2 Purpose of Study 2. Theoretical Framework and Literature Review 2.1 Spatial Catchments and Rural Welfare Service Delivery 2.2 Architectural Spatial Configuration and Operational Flexibility 3. Research Overview 4. Survey Results 4.1 Comparison of combination and Service Provision Status between MtA and Metropolitan Area 4.2 Comparison of Operational and Utilization Conditions of Case Facilities 4.3 Comparison of User Distance to Facility between MtA and Tokyo 5. Discussion 5.1 Combination and Service Provision Conditions 5.2 Architectural Spatial Configuration and Operational Adaptability 5.3 User Travel Distance 5.4 Limitations of the Study 6. Conclusion and Future Tasks Notes References