Honda, Kimiko

写真a

Affiliation

Graduate School of Health Management ( Shinanomachi )

Position

Project Senior Assistant Professor (Non-tenured)/Project Assistant Professor (Non-tenured)/Project Lecturer (Non-tenured)

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Papers 【 Display / hide 】

  • Early detection of proteinuria to prevent kidney fibrosis and progression to kidney failure: lessons from the School Urine Screening Program in Japan

    Rossanti R., Honda K., Honda M., Iijima K.

    Pediatric Nephrology 41 ( 8 ) 2337 - 2346 2026.08

    ISSN  0931041X

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    Chronic kidney disease (CKD) represents a growing global health challenge, often progressing silently until advanced stages. Persistent proteinuria plays a pivotal role in initiating the fibrotic niche—a complex cellular microenvironment contributing to early kidney fibrosis and closely associated with kidney failure. Despite advancements in CKD management, proteinuria remains underrecognized as a critical surrogate endpoint for disease progression. Urine screening for proteinuria in asymptomatic pediatric populations has been contentious due to concerns about diagnostic reliability, cost-effectiveness, and clinical relevance. However, recent data from Japan present a contrasting perspective. With a well-established nationwide school-based urine screening program, Japan has demonstrated effective early detection and intervention strategies, particularly for conditions such as IgA nephropathy. A 2024 economic evaluation reported an incremental cost-effectiveness ratio well below Japan’s pediatric willingness-to-pay threshold, affirming the program’s economic and clinical viability. These findings underscore the potential of structured screening protocols—especially in regions with underreported disease prevalence or limited healthcare access—to prevent long-term kidney impairment. Modifiable factors such as screening frequency, age of initiation, and integration of emerging biomarkers must be considered to optimize outcomes. This review highlights the need to revisit the role of proteinuria screening in pediatric nephrology, advocating for evidence-informed policy decisions that recognize its long-term value. Japan’s model offers a robust framework for balancing cost, clinical impact, and public health priorities in global efforts to address CKD in its earliest stages.

  • Quality of Life Research in Parents and Informal Caregivers of Children With Chronic Illnesses: A Scoping Review

    Honda K., Takai M., Hirono M., Kamono E., Tamori H., Tanaka M., Ogawa K., Hoshino E.

    Academic Pediatrics 26 ( 4 )  2026.05

    ISSN  18762859

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    Objective To map existing research on the quality of life (QOL) of parents and other informal caregivers of children with chronic illnesses, describe study characteristics, caregiver and patient populations, and identify the instruments used to measure QOL and their characteristics. Methods Six databases (MEDLINE, EMBASE, Cochrane Library, PsycINFO, CINAHL, Ichushi) were searched up to October 2024. Eligible studies included parents and other informal caregivers of children with chronic illnesses assessed with multidomain QOL questionnaires. Data on study design, populations, conditions, instruments, and outcomes were extracted, and results were synthesized descriptively using counts and percentages. Results Searches identified 3356 records, of which 409 quantitative studies met the inclusion criteria. The number of publications notably increased since 2020. Most studies were observational (73%) and cross-sectional (62%) with small sample sizes. The most frequently studied conditions of children were developmental disorders, asthma, and atopic dermatitis, accounting for over 40% of the studies. Nearly 44% used generic instruments, 60% of studies used caregiver-specific instruments, and only 2.7% employed both. No preference-based measure (PBM) developed for caregivers of children was identified; existing PBMs target caregivers of adult patients. Conclusions This review shows increasing attention to caregiver QOL in pediatric research, reflected by the increasing number of recent publications. However, it reveals that current evidence remains concentrated on common conditions and is reliant on generic or highly disease-specific instruments. To advance inclusive and evidence-based pediatric care and policy, future studies should broaden disease coverage, adopt more rigorous designs, and develop validated PBMs for caregiving contexts.

  • Conceptual framework for caregivers’ quality of life and well-being supporting children with special health and medical needs in East Asia: asystematic review and narrative synthesis

    Kamono E., Tanaka M., Tamori H., Takai M., Honda K., Ogawa K., Ujino Y., Seino M., Shiroiwa T., Hoshino E.

    Quality of Life Research 34 ( 12 ) 3471 - 3484 2025.12

    ISSN  09629343

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    Purpose: There is a growing need to understand how cultural, relational, and contextual factors shape the quality of life (QOL) and well-being of caregivers of children with special health and medical needs in East Asia. Currently, no culturally grounded conceptual framework exists, and the unique demands of caring for developmentally dependent children present distinct challenges. This study aimed to identify key factors influencing caregiver QOL and well-being in this context. Methods: We conducted a systematic review of qualitative studies examining QOL among caregivers of children with chronic or life-threatening conditions in East Asia. The databases searched included MEDLINE, Cochrane, EMBASE, PsycINFO, CINAHL, and Ichushi (to June 2024). Studies were included if they addressed informal caregiving for children and focused on QOL or well-being in East Asian countries. Existing reviews were used to identify relevant studies, with an additional search conducted for Japan. We applied a framework synthesis approach guided by the EQ-HWB conceptual model. Risk of bias was assessed using the CASP Qualitative Studies Checklist. Results: Fourteen studies met the inclusion criteria. Ten core themes emerged, including emotions, activity, role, social and family relationships, functioning, financial strain, and parenting. Role, family ties, and parenting were especially prominent in East Asian contexts. Conclusions: Caregivers’ experiences were deeply influenced by cultural factors such as collectivism, traditional norms, and stigma. These findings underscore the importance of culturally sensitive frameworks to assess caregiver QOL and to inform policies and interventions in East Asian health and social systems.

  • Decline in the mortality rate of children aged under 20 years with chronic conditions in Japan in 1995–2021

    Kuwahara E., Honda K., Moriichi A.

    Pediatrics International 67 ( 1 )  2025.01

    ISSN  13288067

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    Background: The proportion of children with chronic diseases reaching adulthood is considered to have increased because their mortality rates have been decreasing. This study aimed to estimate mortality rates due to chronic diseases in children and to analyze recent trends. Methods: We selected diseases from the ICD-10 code that could be a cause of death due to chronic diseases in children. Mortality rates due to the selected chronic diseases among individuals under 20 years of age in Japan were calculated using Vital Statistics from 1995 to 2021. Trends were analyzed overall and by 5-year age groups. Results: Overall mortality rates from chronic diseases among individuals aged 0–19 years gradually declined from 18.8 to 8.1 per 100,000 population aged 0–19 years between 1995 and 2021. Annual percent change was −3.92% (95% CI: −4.45, −3.39) from 1995 to 2004 and −2.60% (95% CI: −2.86, −2.34) from 2004 to 2021. The proportion of chronic disease mortality to all-cause mortality, normalized to the 1995 value, showed no significant change during the study period among individuals aged 0–19 years. The most frequent cause of death was congenital malformations of the circulatory system among those aged 0–4 years and neoplasms among those aged 5–9, 10–14, and 15–19 years. Conclusions: Mortality rates from diseases considered chronic in childhood in our analysis have declined for 27 years. Further investigation of disease prevalence is required to clarify the number of adolescents with chronic diseases who reach adulthood.

  • Trends in the integration of medical corporation hospitals in Japan: a national wide longitudinal study between 2017 and 2021

    Funada S., Luo Y., Kato H., Yoshioka T., Uno S., Honda K., Akune Y., Goto R.

    BMC Health Services Research 24 ( 1 )  2024.12

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    Background: Medical corporations, which are non-profit organizations that aim to operate hospitals, clinics, or long-term care facilities, account for more than half of all hospital beds and play a central role in the health care system in Japan. However, limited analysis of hospital integration has been performed. Examining the hospital integration trends of medical corporations can provide valuable insights for optimizing health care delivery and resource allocation in Japan. This study conducted a comprehensive analysis of trends in the hospital integration of medical corporations and market concentration in Japan using nationwide longitudinal data. Methods: This longitudinal study evaluated the hospital integration of medical corporations in Japan between 2017 and 2021 using medical corporation financial data provided by the Neostage Company. The target population was medical corporations that own hospitals in Japan. The primary outcomes were the horizontal and vertical integration of medical corporation hospitals. Horizontal integration was defined as the integration of two or more hospitals within the same corporation, while vertical integration was defined as the integration of a hospital with different types of health care facilities, such as clinics or long-term care facilities, within a single medical corporation. The Herfindahl–Hirschman Index (HHI) was calculated to measure hospital market concentration using hospital bed data for medical corporations in all prefectures. Results: The number of hospitals and hospital beds within medical corporations decreased from 5,670 to 848,174 in 2017 to 5,486 and 814,462 in 2021, respectively. Both horizontal and vertical integration among medical corporation facilities showed a gradual upward trend, increasing from 24.92% to 55.75% in 2017 to 26.92% and 59.42% in 2021, respectively. The mean (standard deviation [SD]) HHI increased slightly from 262.7 (178.6) in 2017 to 275.2 (187.9) in 2021, with rural areas being more concentrated than urban areas, although both remained unconcentrated. Conclusions: This longitudinal study revealed a gradual downward trend in the number of hospitals and hospital beds owned by medical corporations, while horizontal and vertical integration gradually progressed without any particular medical corporation dominating the market. These findings are expected to contribute to policymaking efforts aimed at providing optimal health care services in Japan.

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Papers, etc., Registered in KOARA 【 Display / hide 】

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Research Projects of Competitive Funds, etc. 【 Display / hide 】

  • インフォーマルケアを考慮した、より包括的な小児医療経済評価手法の提案

    2024.07
    -
    2026.03

    研究活動スタート支援, Principal investigator

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Courses Taught 【 Display / hide 】

  • QOL AND COST ANALYSIS

    2026

  • QOL AND COST ANALYSIS

    2025

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