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Forecasting maldistribution of human resources for healthcare and patients in Japan: a utilization-based approach

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Title: Forecasting maldistribution of human resources for healthcare and patients in Japan: a utilization-based approach
Authors: Ishikawa, Tomoki Browse this author
Nakao, Yuji Browse this author
Fujiwara, Kensuke Browse this author
Suzuki, Teppei Browse this author
Tsuji, Shintaro Browse this author
Ogasawara, Katsuhiko Browse this author →KAKEN DB
Keywords: Forecasting
Demand-supply balance
Physician shortage
Utilization-based approach
Issue Date: 9-Sep-2019
Publisher: BioMed Central
Journal Title: BMC health services research
Volume: 19
Issue: 1
Start Page: 653
Publisher DOI: 10.1186/s12913-019-4470-x
PMID: 31500619
Abstract: Background Hokkaido's demographic trend of population decrease with aging population is remarkable even in Japan. Although healthcare policy decision-makers need to appropriately allocate resources while grasping regional demands, not much is available on whether medical demand would increase or not for future. In addition, little is known about what impact will current situation have on future demand-supply balance and equality by regions. This study aims to support decision-making in human resource planning for coping with changing population structure by forecasting future demand, and evaluation those regional maldistributions. Method We set patients with acute myocardial infarction or cerebral stroke, and all medical care as study subjects and analyzed for 2015, 2025, and 2035 in Hokkaido and each Secondary Medical Care Area. We used a utilization-based approach to estimate the healthcare supply-demand balance in the future. Moreover, we evaluated the regional maldistribution of demand-supply balance by calculating Herfindahl-Hirschman Index, Gini Coefficients, the number of physicians/specialists per patient. Moreover, we conducted sensitivity analysis to evaluation impact on aspects of demand-supply balance by uncertainty of utilization for future. Results Our results displayed that concentration of patients will progress, while regional distribution will shrink in all subject. However, from comparison based on all medical care, Gini Coefficients of acute myocardial infarction and cerebral stroke has always been high. This suggest that the resource allocation of them has room for improvement. In addition, our analysis showed the change in this balance will differ in each region in the future. Moreover, demographic change will not consistent with the number of patient change from 2015 to 2035. Conclusion These results suggest policy planners should use the number of patient by disease, by region as indicator of demand, instead of provider-to-population ratios being in use today. The result of our sensitivity analysis show two findings. First, the range of each indicator have possible for future. Second, increase of utilization, for instance lowing barrier in the use by development operation of patient transportation in AMI/CS, would improve maldistribution of opportunity for resident to get emergency medical services.
Type: article
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)

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