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Forecasting the regional distribution and sufficiency of physicians in Japan with a coupled system dynamics : geographic information system model

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Title: Forecasting the regional distribution and sufficiency of physicians in Japan with a coupled system dynamics : geographic information system model
Authors: Ishikawa, Tomoki Browse this author
Fujiwara, Kensuke Browse this author
Ohba, Hisateru Browse this author →KAKEN DB
Suzuki, Teppei Browse this author
Ogasawara, Katsuhiko Browse this author →KAKEN DB
Keywords: Forecasting
Physicians
Physician shortage
Maldistribution
System dynamics
Issue Date: 12-Sep-2017
Publisher: BioMed Central
Journal Title: Human resources for health
Volume: 15
Issue: 1
Start Page: 64
Publisher DOI: 10.1186/s12960-017-0238-8
PMID: 28899406
Abstract: Background: In Japan, the shortage of physicians has been recognized as a major medical issue. In our previous study, we reported that the absolute shortage will be resolved in the long term, but maldistribution among specialties will persist. To address regional shortage, several Japanese medical schools increased existing quota and established "regional quotas." This study aims to assist policy makers in designing effective policies; we built a model for forecasting physician numbers by region to evaluate future physician supply-demand balances. Methods: For our case study, we selected Hokkaido Prefecture in Japan, a region displaying disparities in healthcare services availability between urban and rural areas. We combined a system dynamics (SD) model with geographic information system (GIS) technology to analyze the dynamic change in spatial distribution of indicators. For Hokkaido overall and for each secondary medical service area (SMSA) within the prefecture, we analyzed the total number of practicing physicians. For evaluating absolute shortage and maldistribution, we calculated sufficiency levels and Gini coefficient. Our study covered the period 2010-2030 in 5-year increments. Results: According to our forecast, physician shortage in Hokkaido Prefecture will largely be resolved by 2020. Based on current policies, we forecast that four SMSAs in Hokkaido will continue to experience physician shortages past that date, but only one SMSA would still be understaffed in 2030. Conclusion: The results show the possibility that diminishing imbalances between SMSAs would not necessarily mean that regional maldistribution would be eliminated, as seen from the sufficiency levels of the various SMSAs. Urgent steps should be taken to place doctors in areas where our forecasting model predicts that physician shortages could occur in the future.
Rights: http://creativecommons.org/licenses/by/4.0/
Type: article
URI: http://hdl.handle.net/2115/67574
Appears in Collections:保健科学院・保健科学研究院 (Graduate School of Health Sciences / Faculty of Health Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 小笠原 克彦

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