Geographical distribution of family physicians in Japan: a nationwide cross-sectional study
BACKGROUND: Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6819408/ https://www.ncbi.nlm.nih.gov/pubmed/31664903 http://dx.doi.org/10.1186/s12875-019-1040-6 |
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author | Yoshida, Shuhei Matsumoto, Masatoshi Kashima, Saori Koike, Soichi Tazuma, Susumu Maeda, Takahiro |
author_facet | Yoshida, Shuhei Matsumoto, Masatoshi Kashima, Saori Koike, Soichi Tazuma, Susumu Maeda, Takahiro |
author_sort | Yoshida, Shuhei |
collection | PubMed |
description | BACKGROUND: Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution to this problem. METHODS: We obtained the workplace information of 527 (78.4%) of the 672 JPCA-certified family physicians from an online database. From the national census data, we also obtained the workplace information of board-certified general internists, surgeons, obstetricians/gynaecologists and paediatricians and of all physicians as the same-generation comparison group (ages 30 to 49). Chi-squared test and residual analysis were conducted to compare the distribution between family physicians and other specialists. RESULTS: Five hundred nineteen JPCA-certified family physicians and 137,587 same-generation physicians were analysed. The distribution of family physicians was skewed to municipalities with a lower population density, which shows a sharp contrast to the urban-biased distribution of other specialists. The proportion of family physicians in non-metropolitan municipalities was significantly higher than that expected based on the distribution of all same-generation physicians (p < 0.001). CONCLUSIONS: Family physicians distributed in favour of rural areas much more than any other specialists in Japan. The better balance of family physician distribution reported from countries with a strong primary care orientation seems to hold even in a country where primary care orientation is weak, physician distribution is not regulated, and patients have free access to healthcare. Family physicians comprise only 0.2% of all Japanese physicians. However, if their population grows, they can potentially rectify the imbalance of physician distribution. Government support is mandatory to promote family medicine in Japan. |
format | Online Article Text |
id | pubmed-6819408 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-68194082019-10-31 Geographical distribution of family physicians in Japan: a nationwide cross-sectional study Yoshida, Shuhei Matsumoto, Masatoshi Kashima, Saori Koike, Soichi Tazuma, Susumu Maeda, Takahiro BMC Fam Pract Research Article BACKGROUND: Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution to this problem. METHODS: We obtained the workplace information of 527 (78.4%) of the 672 JPCA-certified family physicians from an online database. From the national census data, we also obtained the workplace information of board-certified general internists, surgeons, obstetricians/gynaecologists and paediatricians and of all physicians as the same-generation comparison group (ages 30 to 49). Chi-squared test and residual analysis were conducted to compare the distribution between family physicians and other specialists. RESULTS: Five hundred nineteen JPCA-certified family physicians and 137,587 same-generation physicians were analysed. The distribution of family physicians was skewed to municipalities with a lower population density, which shows a sharp contrast to the urban-biased distribution of other specialists. The proportion of family physicians in non-metropolitan municipalities was significantly higher than that expected based on the distribution of all same-generation physicians (p < 0.001). CONCLUSIONS: Family physicians distributed in favour of rural areas much more than any other specialists in Japan. The better balance of family physician distribution reported from countries with a strong primary care orientation seems to hold even in a country where primary care orientation is weak, physician distribution is not regulated, and patients have free access to healthcare. Family physicians comprise only 0.2% of all Japanese physicians. However, if their population grows, they can potentially rectify the imbalance of physician distribution. Government support is mandatory to promote family medicine in Japan. BioMed Central 2019-10-29 /pmc/articles/PMC6819408/ /pubmed/31664903 http://dx.doi.org/10.1186/s12875-019-1040-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Yoshida, Shuhei Matsumoto, Masatoshi Kashima, Saori Koike, Soichi Tazuma, Susumu Maeda, Takahiro Geographical distribution of family physicians in Japan: a nationwide cross-sectional study |
title | Geographical distribution of family physicians in Japan: a nationwide cross-sectional study |
title_full | Geographical distribution of family physicians in Japan: a nationwide cross-sectional study |
title_fullStr | Geographical distribution of family physicians in Japan: a nationwide cross-sectional study |
title_full_unstemmed | Geographical distribution of family physicians in Japan: a nationwide cross-sectional study |
title_short | Geographical distribution of family physicians in Japan: a nationwide cross-sectional study |
title_sort | geographical distribution of family physicians in japan: a nationwide cross-sectional study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6819408/ https://www.ncbi.nlm.nih.gov/pubmed/31664903 http://dx.doi.org/10.1186/s12875-019-1040-6 |
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