Trend in geographic distribution of physicians in Japan
Trend in geographic distribution of physicians in Japan
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DOI：
10.1186/1475-9276-8-5
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发表时间：
2009-03-03
影响因子：
4.8
通讯作者：
Toyabe, Shin-ichi
中科院分区：
文献类型：
--
作者：
Toyabe, Shin-ichi
背景资料：自1980年代后期以来，日本政府关于医生人力的政策一直是减少医学生的数量。然而，近年来日本医生短缺已成为一个社会问题。本研究的目的是比较1996年至2006年期间日本医生的数量和分布的趋势。方法：分析1996年至2006年期间医生数量和分布的时间趋势。基尼系数，阿特金森指数和泰尔指数被用来衡量医生的人口分布不均。结果：1996 ~ 2006年，河南省医师人数逐年增加，但仍低于国际水平。2004年后，医生分布不均的三个指标都恶化了，在医院工作的医生分布的恶化是显著的。在城市地区，在医院工作的医生人数显著增加，但在人口密度低的地区则没有增加。当医学实习生被排除在计算，分配不均的措施improved.Conclusion：在日本的医生短缺的问题是与医生的绝对数量和医院医生的分布不均的短缺。新的研究生实习制度可能会使这种情况恶化。
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.