Physician Distribution by Specialty and Practice Setting: Findings in Japan in 2000, 2010 and 2016

Ikesu, Ryo; Miyawaki, Atsushi; Kobayashi, Yasuki

doi:10.1620/tjem.251.1

Cited by 12 publications

(11 citation statements)

References 12 publications

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“…The Ministry of Health, Labor and Welfare (MHLW) has recently recognized a shortage and uneven distribution of local medical professionals involved in CKD treatment [ 48 ]. This maldistribution in the workforce seems to originate from the existing practice of projecting the workforce that is based on the provider-to-population ratio rather than population demand or population needs [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Elucidating variations in outcomes among older end-stage renal disease patients on hemodialysis in Fukuoka Prefecture, Japan

Jamal

Babazono

et al. 2021

PLoS ONE

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Variations in health care outcomes and services potentially indicate resource allocation inefficiency. Therefore, this study was conducted to examine variations in mortality and hospitalization cases among end-stage renal disease (ESRD) patients receiving hemodialysis (HD) care from medical facilities located in 13 secondary medical care areas (SMAs) of Fukuoka prefecture, Japan. The research was designed as a retrospective, cross-sectional study using insurance claims data. The subjects of the study were older patients (over 65 years old) insured by the Fukuoka prefecture’s Latter-Stage Elderly Healthcare Insurance. Using an electronic claims database, we identified patients with chronic kidney disease (CKD) who had received HD care from April 1, 2017 to March 31, 2018. The CKD status was identified using International Classification of Disease, 10th revision code, and HD maintenance status was ascertained using specific insurance procedure codes. A total of 5,243 patients met our inclusion criteria and their records were subsequently reviewed. About 73% (n = 3,809) of patients had admission records during the period studied. Thus, the data regarding hospital length of stay (LOS) and admission costs were analyzed separately. Significant differences in terms of increased risks in hospitalization were evident in a number of SMAs. An increase in mortality risk due to heart failure and malignancy was observed in two separate SMAs. Also, analyzed LOS, total hospitalization cost, and cost per day according to SMAs showed statistically significant variations. The findings highlight the magnitude of the burden of CKD and ESRD in the community. The high prevalence of ESRD, associated mortality, and hospitalized HD patients signal the need for clinicians to assume broader roles in measures against chronic kidney disease through involvement in community awareness programs. To improve patient outcomes, improvement of regional health care provision, the level of medical care, and the development of existing human resources are needed.

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Section: Discussionmentioning

confidence: 99%

Elucidating variations in outcomes among older end-stage renal disease patients on hemodialysis in Fukuoka Prefecture, Japan

Jamal

Babazono

et al. 2021

PLoS ONE

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“…In Japan, the shortage of physicians, including psychiatrists, has recently become a serious public health issue [10,11]. Several studies have indicated that the cause of this shortage is related not only to the absolute number of physicians but also to their maldistribution [12,13]. Regarding the mental healthcare system in Japan, the absolute number of psychiatrists increased from 1996 to 2012, while the GC based on the number of physicians per population did not change during the same period [14].…”

Section: Discussionmentioning

confidence: 99%

Projections of Psychiatrists’ Distribution for Patients in Japan: A Utilization-Based Approach

Sugawara

Yasui‐Furukori

Saito

2020

Preprint

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Background: Depopulation accompanied by population aging is a major public health concern in Japan. Although adequate allocation of mental healthcare resources is needed, there have been few studies on the impact of population change on the supply-demand balance for mental illness in Japan. The aim of this study is to predict psychiatrists' distribution for patients with mental illness via a utilization-based approach.Methods: We set patients with schizophrenia, mood disorders, vascular dementia or Alzheimer’s disease as study subjects and conducted analyses for 2015, 2025, 2035, and 2045 across all prefectures. Moreover, we evaluated the regional maldistribution of demand and supply by calculating the number of psychiatrists per patient, Gini coefficients (GC), and Herfindahl-Hirschman Index (HHI).Results: The mean number of psychiatrists per patient for patients with schizophrenia, mood disorders, vascular dementia, and Alzheimer’s disease in 2025, 2035, and 2045 was significantly lower than in 2015. For all of the abovementioned diseases, both the GC and HHI will increase until 2045.Conclusion: If psychiatrists are allocated at the current population-to-psychiatrist ratio, the shortage of psychiatrists will continue to worsen in the future. To overcome this inequity, policy makers should make plans for the adequate geographical allocation of healthcare resources or the use of information and communication technologies for the delivery of health services to rural communities.

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“…government and Academic Societies that have promoted the selection and concentration of obstetric hospitals [20,21]. If the obstetrics/gynecology workforce continues to decline, it will force individual doctors in the facilities that handle delivery to overwork, and concurrently lead to a decline in the quality of obstetric care.…”

Section: Plos Onementioning

confidence: 99%

The geographical maldistribution of obstetricians and gynecologists in Japan

et al. 2021

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Background In Japan, there is a large geographical maldistribution of obstetricians/gynecologists, with a high proportion of females. This study seeks to clarify how the increase in the proportion of female physicians affects the geographical maldistribution of obstetrics/gynecologists. Methods Governmental data of the Survey of Physicians, Dentists and Pharmacists between 1996 and 2016 were used. The Gini coefficient was used to measure the geographical maldistribution. We divided obstetricians/gynecologists into four groups based on age and gender: males under 40 years, females under 40 years, males aged 40 years and above, and females aged 40 years and above, and the time trend of the maldistribution and contribution of each group was evaluated. Results The maldistribution of obstetricians/gynecologists was found to be worse during the study period, with the Gini coefficient exceeding 0.400 in 2016. The contribution ratios of female physicians to the deterioration of geographical maldistribution have been increasing for those under 40 years and those aged 40 years and above. However, there was a continuous decrease in the Gini coefficient of the two groups. Conclusions The increase in the contribution ratio of the female physician groups to the Gini coefficient in obstetrics/gynecology may be due to the increased weight of these groups. The Gini coefficients of the female groups were also found to be on a decline. Although this may be because the working environment for female physicians improved or more female physicians established their practice in previously underserved areas, such a notion needs to be investigated in a follow-up study.

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Physician Distribution by Specialty and Practice Setting: Findings in Japan in 2000, 2010 and 2016

Cited by 12 publications

References 12 publications

Elucidating variations in outcomes among older end-stage renal disease patients on hemodialysis in Fukuoka Prefecture, Japan

Elucidating variations in outcomes among older end-stage renal disease patients on hemodialysis in Fukuoka Prefecture, Japan

Projections of Psychiatrists’ Distribution for Patients in Japan: A Utilization-Based Approach

The geographical maldistribution of obstetricians and gynecologists in Japan

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