Widening disparity in the geographic distribution of pediatricians in Japan.
Widening disparity in the geographic distribution of pediatricians in Japan.
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DOI：
10.1186/1478-4491-11-59
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发表时间：
2013-11-22
影响因子：
4.5
通讯作者：
Imanaka Y
中科院分区：
文献类型：
--
作者：
Sasaki H;Otsubo T;Imanaka Y
日本医生短缺是一个严重问题，特别是在儿科等专业领域。本研究的目的是调查儿科医生地理分布的最新变化以及造成这种变化的因素。我们使用人口规模、社会和经济地位以及儿科服务提供等归因变量，调查了日本 369 个二级医疗地区每 10 万名 15 岁以下人口中儿科医生队伍的数量变化（2002 年至 2007 年）。我们进行了主成分分析和多元回归分析。我们获得了两个主要组成部分：一个反映了城市化程度，另一个反映了儿科服务提供量。只有第一个部分得分与每 10 万名 15 岁以下人口中儿科医生数量的增加呈正相关。我们根据成分分数将次要医疗领域分为四组。这一时期儿科医生劳动力的增加主要被城市化水平较高的两个群体所吸收，而两个农村群体的增长幅度较小。 50 至 59 岁的儿科医生在所有四个组中均有所增加，而 30 至 39 岁的儿科医生在两个农村组中均有所减少，而在两个城市组中则有所增加。儿科医生劳动力的增长趋势总体上与城市化同步，但与儿科医生原有的劳动力供给无关。儿科医生的地理分布呈现出向城市快速集中的趋势。这一趋势在女性儿科医生和 30 至 39 岁的儿科医生中尤为明显。鉴于农村地区老年儿科医生没有被年轻医生取代，当高级医生退休时，这些地区可能会面临新的危机。
The shortage of physicians in Japan is a serious concern, particularly in specialties like pediatrics. The purpose of this study was to investigate recent changes in the geographic distribution of pediatricians and the factors underlying this change. We investigated the numerical changes in the pediatrician workforce (2002 to 2007) per 100,000 of the population under the age of 15 years in 369 secondary medical areas throughout Japan, using attributive variables such as population size, social and economic status, and pediatric service delivery. We performed principal component analysis and multiple regression analysis. We obtained two principal components: one that reflected the degree of urbanization and another that reflected the volume of pediatric service delivery. Only the first component score was positively correlated with an increased pediatrician workforce per 100,000 of the population under the age of 15 years. We classified the secondary medical areas into four groups using component scores. The increase in pediatrician workforce during this period was primarily absorbed into the two groups with higher levels of urbanization, whereas the two rural groups exhibited little increase. Pediatricians aged 50 to 59 years increased in all four groups, whereas pediatricians aged 30 to 39 years decreased in the two rural groups and increased in the two urban groups. The trends of the pediatrician workforce increase generally kept pace with urbanization, but were not associated with the original pediatrician workforce supply. The geographic distribution of pediatricians showed rapid concentration in urban areas. This trend was particularly pronounced among female pediatricians and those aged 30 to 39 years. Given that aging pediatricians in rural areas are not being replaced by younger doctors, these areas will likely face new crises when senior physicians retire.
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影响因子：
2.8
作者：
Kawasaki, Kazuyoshi;Sekimoto, Miho;Imanaka, Yuichi
通讯作者：
Imanaka, Yuichi
影响因子：
4.7
作者：
Koike, Soichi;Kodama, Tomoko;Imamura, Tomoaki
通讯作者：
Imamura, Tomoaki
影响因子：
2.4
作者：
Gravelle, H;Sutton, M
通讯作者：
Sutton, M
DOI：
10.1111/j.1467-842x.2000.tb00726.x
发表时间：
2000-02-01
影响因子：
3.5
作者：
Wilkinson, D;Symon, B
通讯作者：
Symon, B
影响因子：
4.7
作者：
Onishi, H;Yoshida, I
通讯作者：
Yoshida, I