Trends in the geographic distribution of nursing staff before and after the Great East Japan Earthquake: a longitudinal study.
Trends in the geographic distribution of nursing staff before and after the Great East Japan Earthquake: a longitudinal study.
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DOI：
10.1186/s12960-015-0067-6
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发表时间：
2015-08-25
影响因子：
4.5
通讯作者：
Kobayashi Y
中科院分区：
文献类型：
--
作者：
Morioka N;Tomio J;Seto T;Kobayashi Y
2011年3月11日发生的东日本大地震（GEJE）严重破坏了岩手县、宫城县和福岛县的医疗系统。这一领域的护士短缺令人关切;然而，尚未对时间趋势进行调查。本研究的目的是调查在地理分布的趋势，总的护理人员每人口在二级医疗区（SMA）的这些都道府县之前和之后的GEJE。我们还旨在对上述趋势进行定性。我们在6年内的四个时间点（2007年7月、2010年7月、2011年7月和2013年7月）进行了一项纵向研究，使用了岩手县、宫城县和福岛县内遭受严重破坏的所有医院的基本住院费用报告。我们计算了SMA中每个人群的护理人员总数，并编制了描述性统计数据。对2010年至2013年的变化进行了定性和绘图。在沿海SMA，总护理人员与人口的比例下降后立即GEJE。2013年，在大多数工作人员管理协议中，这一比率有所增加，超过了《平等就业机会法》实施前的水平。但是，从2010年到2013年，平均每个人口的护理人员总数的变化在凉坂（-4.0%）、石卷留气仙沼（-1.9%）、总总（-47.7%）和磐城市（-1.9%）为负值。在距离福岛第一核电站最近的寿市，按工作角色划分的每人口护理人员总数的变化为护士-33.7%，助理护士-57.7%，护理助理-63.2%。我们的研究表明，在身体受损地区和受辐射影响地区，由于GEJE，每个人口的护理人员总数的时间趋势不同。我们还发现，按资格划分的趋势有所不同：受辐射影响最严重的地区Sousou的人均护理人员总数减少幅度大于任何其他SMA。此外，在这三类员工中，护理助理的人数受影响最大。为了促进GEJE后医疗保健系统的重建，可能有必要制定政策来确保核灾难后护士和护理助理的安全。
Medical care systems in Iwate, Miyagi and Fukushima prefectures were greatly damaged by the Great East Japan Earthquake (GEJE), which struck on 11 March 2011. The shortage of nurses in this area was concerning; however, temporal trends have not been investigated. This study aimed to investigate the trends in the geographic distribution of total nursing staff per population in the secondary medical areas (SMAs) of these prefectures before and after the GEJE. We also aimed to qualify the above trends. We conducted a longitudinal study at four time points (July 2007, 2010, 2011 and 2013) over 6 years using reports of basic hospitalization charges from all hospitals within Iwate, Miyagi and Fukushima prefectures that experienced severe damage from the GEJE. We calculated the number of total nursing staff per population in the SMAs and compiled descriptive statistics. Changes from 2010 to 2013 were qualified and mapped. In coastal SMAs, the ratios of total nursing staff per population decreased immediately after the GEJE. In most SMAs in 2013, the ratios increased and exceeded the pre-GEJE level. However, the changes in total nursing staff per population from 2010 to 2013 were negative in Ryouban (−4.0%), Ishinomaki–Tome–Kesennuma (−1.9%), Sousou (−47.7%) and Iwaki (−1.9%). In Sousou, which is closest to the Fukushima Daiichi Nuclear Power Plant, the changes in total nursing staff per population qualified by job role were −33.7% for nurses, −57.7% for associate nurses and −63.2% for nursing aides. Our study indicated that the temporal trends in the number of total nursing staff per population due to the GEJE differed between the physically damaged areas and those affected by radiation. We also found the difference in the trend by qualifications: the reduction in total nursing staff per population was larger in Sousou, the area most affected by radiation, than in any other SMAs. Moreover, the number of nursing aides was most affected among the three types of staff. To promote the post-GEJE reconstruction of medical care systems, it might be necessary to develop policies to secure both nurses and nursing aides after nuclear disasters.