Allocation of doctors and hospitals which meets the demanded level of medical service

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Recently the shortage of obstetricians has been critical issue in Japan. In this research we examine the reason of the shortage. By estimations using micro simulations and GIS systems, we got three main findings. 1. As a result of too many hospitals in Japan, the operation rate of obstetricians is low and inefficient. If we take the current hospitals are given, we need more obstetricians. 2. It is impossible to train obstetricians shortly to fulfill the demand we estimated for the younger population in Japan are decreasing. 3. Integrating small hospitals will improve the operation rate of obstetricians and may solve the shortage problem. But such integration will prolong the average access time from residences of the patients to the hospitals. Our simulations show that the access time may be longer beyond the medical tolerance in some prefectures with low population density. This means that the integration should be planned to match the local situation.