Aging of hospital physicians in rural Japan: A longitudinal study based on national census data
Aging of hospital physicians in rural Japan: A longitudinal study based on national census data
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DOI：
10.1371/journal.pone.0198317
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发表时间：
2018-06-01
期刊：
影响因子：
3.7
通讯作者：
Tazuma, Susumu
中科院分区：
文献类型：
--
作者：
Matsumoto, Masatoshi;Kimura, Kazuki;Tazuma, Susumu
研究背景在日本，城乡医生数量的不均衡是一个社会问题。医生的年龄也可能存在差异。本研究纵向研究的地理和年龄分布的医生。MethodsIndividual数据从调查的医生，牙医和药剂师在1994年，2004年和2014年和市政数据从全国人口普查。2015年的市镇边界适用于所有年份，所有市镇都根据人口密度被划分为相同大小的五分之一。两个城市和医生纵向observed.ResultsBetween 1994年和2014年，每10万人口的医生数量增加了31.8%，在最城市组的城市和17.4%，在最农村组。医生的平均年龄在大多数农村地区最高，在大多数城市地区最低。城乡医生平均年龄差距从1994年的2.1岁扩大到2014年的6.0岁。这一差距在医院医生中尤为明显（从1994年的1.5年到2014年的7.6年）。在大多数农村群体中，40岁以下的医院医生人数减少了59.4%，而55-70岁的人数增加了153%，70岁以上的人数增加了41.0%。在1994年至2004年期间，40岁以下的医院医生只有23.0%保留在最农村组，2004年至2014年期间的留存率下降到19.3%，而老年医生的比率增加。农村地区医生短缺的情况可能比医生人数显示的情况更为严重。
BackgroundThe disparity in the number of urban and rural physicians is a social problem in Japan. There may also be a disparity in the age of physicians. This study longitudinally examines both geographic and age distributions of physicians.MethodsIndividual data from the Survey of Physicians, Dentists and Pharmacists in 1994, 2004 and 2014 and municipality data from the National Population Census were used. The 2015 municipality border was applied to all years, and all municipalities were classified into equalsize quintiles based on population density. Both municipalities and physicians were longitudinally observed.ResultsBetween 1994 and 2014, the number of physicians per 100,000 population increased by 31.8% in the most urban group of municipalities and 17.4% in the most rural group. The average age of physicians was highest in the most rural and lowest in the most urban group. The difference in average age between the urban and rural physicians widened from 2.1 years in 1994 to 6.0 years in 2014. This disparity is particularly pronounced among hospital physicians (from 1.5 years in 1994 to 7.6 years in 2014). In the most rural group, the number of hospital physicians younger than 40 years old has decreased by 59.4%, while the number of those 55-70 has grown by 153% and the number older than 70 years old by 41.0%. Between 1994 and 2004, only 23.0% of hospital physicians younger than 40 years old were retained in the most rural group; the retention rate fell to 19.3% between 2004 and 2014, while the rates increased in older physicians.ConclusionsThe uneven distribution of physicians is increasing in Japan, as is the aging of rural hospital physicians. Shortage of physicians in rural areas may be more serious than that shown as their headcount.