The geographical maldistribution of obstetricians and gynecologists in Japan

Abstract

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.

The allocation and fairness of health human resources in Chinese maternal and child health care institutions: a nationwide longitudinal study

“…Similar situations also existed in other countries, such as Kenya, Mexico, Vietnam, Japan, Mongolia, etc. [ 37 , 40 , 41 ]. The unfair geographical allocation of health resources would restrict the rational allocation and management of health resources, and ultimately affect the fairness and accessibility of health services.…”

Pandemide Geriatrik Nüfusun Sağlık Çalışanlarından Sağladığı Sosyal Faydada Yaşanan Artış

“…However, the number of studies and countries in which egalitarian development that supports interregional convergence can be identified is extremely limited (35)(36)(37)(38). Studies showing that there is more interregional divergence and exacerbation of the imbalance are dominant (26)(27)(28)(29)(30)(31)(32)(33)(34). In addition, there is a serious gap in the literature on studies that include interregional distribution according to the elderly people.…”

“…Toyabe (28) found that there was a deterioration in the interregional distribution of health workers, which examined the years between 1996 and 2006, in Japan after 2004. Matsumoto et al (29) found that inequality in the interregional distribution of obstetrics/gynecology increased between 1996 and 2016 in Japan.…”

Incorporating Medical Supply and Demand into the Index of Physician Maldistribution Improves the Sensitivity to Healthcare Outcomes

“…However, the extreme variations in rural disadvantages and challenges in defining and designating rural areas remain a crucial hurdle [ 50 ]. It is also worth noting that geographic disparities in the distribution of specialist physicians remain an area of concern in Japan [ 51 ] as well as in countries such as the US [ 52 ] and Canada [ 53 ]. Yet, none of the indices used to assess physician distribution, including the PUDI, reflect the regional demand and supply of the medical subspecialty workforce to deal with the varying burden of specific conditions in one region versus another.…”