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Trend in geographic distribution of physicians in Japan.

Toyabe S - Int J Equity Health (2009)

Bottom Line: Since the late 1980s, the policy of the Japanese government regarding physician manpower has been to decrease the number of medical students.The number of physicians working at hospitals has significantly increased in urban areas but not in areas with low population densities.When medical interns were excluded from calculation, the measures of mal-distribution improved.

View Article: PubMed Central - HTML - PubMed

Affiliation: Crisis Management Office, Niigata University Medical and Dental Hospital, Asahimachi-Dori1-754, Chuo-Ku, Niigata City 951-8520, Japan. toyabe@med.niigata-u.ac.jp.

ABSTRACT

Background: Since the late 1980s, the policy of the Japanese government regarding physician manpower has been to decrease the number of medical students. However, the shortage of doctors in Japan has become a social problem in recent years. The aim of this study was to compare the numbers of physicians in Japan between 1996 and 2006 and the trends in distribution of physicians.

Methods: The time trends in number and distribution of physicians between 1996 and 2006 were analyzed. Gini coefficient, Atkinson index and Theil index were used as measures for mal-distribution of physicians to population. The distribution of physicians was visualized on a map by using geographic information system (GIS) software.

Results: The total number of physicians increased every year in the period from 1996 to 2006 but has remained below the international standard. All three measures of mal-distribution of physicians worsened after 2004, and the worsening was remarkable in the distribution of physicians working at hospitals. The number of physicians working at hospitals has significantly increased in urban areas but not in areas with low population densities. When medical interns were excluded from calculation, the measures of mal-distribution improved.

Conclusion: The problem of a doctor shortage in Japan is linked to both the shortage of absolute number of physicians and the mal-distribution of hospital physicians. The new postgraduate internship system might worsen this situation.

No MeSH data available.


Year-to-year trends in numbers of physicians in Japan. Numbers of physicians practicing at general hospitals (open circles), university hospitals (open triangles) and clinics (crosses) in six time periods are shown (A). Increment ratios in numbers of physicians compared with those in 1996 are also shown (B).
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Figure 1: Year-to-year trends in numbers of physicians in Japan. Numbers of physicians practicing at general hospitals (open circles), university hospitals (open triangles) and clinics (crosses) in six time periods are shown (A). Increment ratios in numbers of physicians compared with those in 1996 are also shown (B).

Mentions: Both the total number of physicians and the average ratio of physicians to population have been increasing every year (Figure 1, Table 1). The number of practicing physicians has been increasing by 3,000 (1.3%) every year. At present, there are about 260,000 practicing physicians in Japan, and the overall ratio of practicing physicians to 100,000 population is 206.3 (Table 1). Forty-seven percent of physicians are working at general hospitals, 36% are practicing at clinics, and 17% are working at university hospitals.


Trend in geographic distribution of physicians in Japan.

Toyabe S - Int J Equity Health (2009)

Year-to-year trends in numbers of physicians in Japan. Numbers of physicians practicing at general hospitals (open circles), university hospitals (open triangles) and clinics (crosses) in six time periods are shown (A). Increment ratios in numbers of physicians compared with those in 1996 are also shown (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2662844&req=5

Figure 1: Year-to-year trends in numbers of physicians in Japan. Numbers of physicians practicing at general hospitals (open circles), university hospitals (open triangles) and clinics (crosses) in six time periods are shown (A). Increment ratios in numbers of physicians compared with those in 1996 are also shown (B).
Mentions: Both the total number of physicians and the average ratio of physicians to population have been increasing every year (Figure 1, Table 1). The number of practicing physicians has been increasing by 3,000 (1.3%) every year. At present, there are about 260,000 practicing physicians in Japan, and the overall ratio of practicing physicians to 100,000 population is 206.3 (Table 1). Forty-seven percent of physicians are working at general hospitals, 36% are practicing at clinics, and 17% are working at university hospitals.

Bottom Line: Since the late 1980s, the policy of the Japanese government regarding physician manpower has been to decrease the number of medical students.The number of physicians working at hospitals has significantly increased in urban areas but not in areas with low population densities.When medical interns were excluded from calculation, the measures of mal-distribution improved.

View Article: PubMed Central - HTML - PubMed

Affiliation: Crisis Management Office, Niigata University Medical and Dental Hospital, Asahimachi-Dori1-754, Chuo-Ku, Niigata City 951-8520, Japan. toyabe@med.niigata-u.ac.jp.

ABSTRACT

Background: Since the late 1980s, the policy of the Japanese government regarding physician manpower has been to decrease the number of medical students. However, the shortage of doctors in Japan has become a social problem in recent years. The aim of this study was to compare the numbers of physicians in Japan between 1996 and 2006 and the trends in distribution of physicians.

Methods: The time trends in number and distribution of physicians between 1996 and 2006 were analyzed. Gini coefficient, Atkinson index and Theil index were used as measures for mal-distribution of physicians to population. The distribution of physicians was visualized on a map by using geographic information system (GIS) software.

Results: The total number of physicians increased every year in the period from 1996 to 2006 but has remained below the international standard. All three measures of mal-distribution of physicians worsened after 2004, and the worsening was remarkable in the distribution of physicians working at hospitals. The number of physicians working at hospitals has significantly increased in urban areas but not in areas with low population densities. When medical interns were excluded from calculation, the measures of mal-distribution improved.

Conclusion: The problem of a doctor shortage in Japan is linked to both the shortage of absolute number of physicians and the mal-distribution of hospital physicians. The new postgraduate internship system might worsen this situation.

No MeSH data available.