Urbanization and physician maldistribution: a longitudinal study in Japan
BMC Health Services ResearchPublished 8 October 2011Open access
Shinichi Tanihara, Yasuki Kobayashi, Hiroshi Une, Ichiro Kawachi
Citations117
SJR quartileQ1
SJR score1.17
SNIP1.31
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
A policy that increased the number of physicians and the physician to population ratios between 1998 and 2008 in all geographic areas of Japan, irrespective of size, did not lead to a more equal geographical distribution of physicians.
Abstract
A policy that increased the number of physicians and the physician to population ratios between 1998 and 2008 in all geographic areas of Japan, irrespective of size, did not lead to a more equal geographical distribution of physicians. The ratios of physicians to population in small rural STMs increased because of concurrent trends in urbanization and not because of a rise in the number of practicing physicians.
Keywords
Health ProfessionsEconomics, Econometrics and Finance
ScienceSmall Area Variations in Health Care Delivery
1,883 Citations1973John E. Wennberg, Alan M. Gittelsohn
Numbers show prima facie inequalities in the input of resources that are associated with income transfer from areas of lower expenditure to areas of higher expenditure, which indicates that there is considerable uncertainty about the effectiveness of different levels of aggregate, as well as specific kinds of, health services.
Health & PlaceAssessing spatial and nonspatial factors for healthcare access: towards an integrated approach to defining health professional shortage areas
659 Citations2004Fahui Wang, Wei Luo
This research considers both spatial and nonspatial factors in examining accessibility to primary healthcare in Illinois to develop an integrated approach for defining Health Professional Shortage Areas (HPSA) that may help the US Department of Health and Human Services and state health departments improve HPSA designation.
Health Services ResearchThe Geographic Distribution of Physicians Revisited
226 Citations2005Meredith B. Rosenthal, Alan M. Zaslavsky +1 more
Geographic access to physicians has continued to improve over the past two decades, although some smaller specialties have not diffused to the most rural areas, and current measures of geographic access overstate the extent of maldistribution.
Health Services ResearchPrimary Care Service Areas: A New Tool for the Evaluation of Primary Care Services
192 Citations2003David C. Goodman, Stephen S. Mick +6 more
Primary Care Service Areas are a new tool for the measurement of primary care resources, utilization, and associated outcomes and policymakers at all jurisdictional levels as well as researchers will have a standardized system of geographical units through which to assess access to, supply, use, organization, and financing of primary Care services.
The LancetGeographic distribution of physicians in Japan
188 Citations1992Yasuki Kobayashi, Haruyoshi Takaki
Analysis of the numbers of physicians in relation to the population in all municipal bodies in Japan between 1980 and 1990 indicated that the inequality in physician distribution did not improve, and while municipal bodies with a population over 30,000 gained proportionally more physicians, most communities with fewer than 10,000 residents showed little gain.
New England Journal of MedicineThe Changing Geographic Distribution of Board-Certified Physicians
185 Citations1980William B. Schwartz, Joseph P. Newhouse +2 more
If an increase in physician supply has been the major force responsible for the movement into nonmetropolitan areas, this trend implies that smaller and smaller towns will acquire board-certified specialists as the number of physicians increases.
International Journal for Equity in HealthTrend in geographic distribution of physicians in Japan
162 Citations2009Shin‐ichi Toyabe
The problem of a doctor shortage in Japan is linked to both the shortage of absolute number of physicians and the mal-distribution of hospital physicians.
Health PolicyTrends in geographic disparities in allocation of health care resources in the US
148 Citations2004Tuvia Horev, Irena Pesis-Katz +1 more
Examination of current level and historical trends in health resources distribution in the US finds physician distribution has become less equitable, while hospital-beds' equity has increased, and rates per capita might not be sufficient in determining availability of resources.
Health PolicyGeographical distributions of physicians in Japan and US: Impact of healthcare system on physician dispersal pattern
146 Citations2010Masatoshi Matsumoto, Kazuo Inoue +4 more
In spite of constant growth of physician numbers, physicians do not diffuse according to population distribution in Japan and the US, and rather, US physicians seem to disperse according to income distribution.
PEDIATRICSAre We There Yet? Distance to Care and Relative Supply Among Pediatric Medical Subspecialties
127 Citations2006Michelle L. Mayer
The findings suggest that either the supply of pediatric subspecialists is inadequate, pediatric sub Specialties are distributed inequitably, or the market for pediatric sub specialists is larger than the hospital referral regions.
PubMedThe maldistribution of general practitioners in England and Wales: 1974-2003.
103 Citations2004Mark Hann, Hugh Gravelle
Maldistribution of GPs as measured by the Gini coefficient and Atkinson index increased from the mid-1980s to 2003, but the decile ratio showed little change over the entire 1974-2003 period.
BMC Health Services ResearchHospital service areas – a new tool for health care planning in Switzerland
100 Citations2005Gunnar Klauss, Lukas Staub +2 more
The methodology to create and characterize population-based hospital service areas (HSAs) for Switzerland and introduced novel planning variables extracted from the patient origin study to understand patient travel patterns for hospital use is presented.
Annual Review of Public HealthGeographic Access to Physician Services
94 Citations1990Joseph P. Newhouse
Prior to the last decade, it was widely accepted that physicians were geo graphically maldistributed; indeed, a major federal initiative, the National Health Service Corps, was based on that premise (24).
BMC Health Services ResearchPrimary care physician supply and other key determinants of health care utilisation: the case of Switzerland
89 Citations2008André Busato, Beat Künzi
Effects of physician density appeared to be strongly related to Swiss language regions and may be rooted in the different cultural backgrounds of the served populations in the multicultural population of Switzerland.
Medical CareTravel for Ambulatory Medical Care
79 Citations1983Joel C. Kleinman, Diane M. Makuc
Travel patterns for ambulatory care based on the 1978 National Health Interview Survey are described, finding that travel patterns for the usual source of care are similar to those for primary care physician visits.
PEDIATRICSTrends in the Rural-Urban Distribution of General Pediatricians
69 Citations2001Greg D. Randolph, Donald E. Pathman
The near doubling in general pediatrician numbers from 1981 to 1996 yielded only a modest increase in pediatrician availability for rural children, and the discrepancy between urban and rural pediatrician supply increased during this period.
Social Science & MedicineThe association between heart disease mortality and geographic access to hospitals: County level comparisons in Ohio, USA
56 Citations2010Takashi Yamashita, Suzanne Kunkel
This study demonstrates the usefulness of visualized health data and makes a case for further research on associations between disease outcomes and access to health care services.
Rural and Remote HealthTransition of physician distribution (1980-2002) in Japan and factors predicting future rural practice
54 Citations2009Kazuo Inoue, Masatoshi Matsumoto +2 more
Baseline rural practice, primary care discipline and male sex of physicians were found to be predictors of rural practice after 22 years, and the rapid increase of physicians between 1980 and 2002 has not substantially affected their geographic distribution.
PEDIATRICSPediatrician Workforce Statement
41 Citations2005
This statement discusses the importance of pediatrician-workforce issues and their relevance to the provision of pediatric health care and identifies both overarching policy goals for the pediatrician workforce and implementation strategies designed to ensure that all of America's infants, children, adolescents, and young adults have access to appropriate pediatric health Care.
The Tohoku Journal of Experimental MedicineThe Shortage of Pediatrician Workforce in Rural Areas of Japan
34 Citations2009Kyoko Nomura, Satoshi Inoue +1 more
The absolute numbers of pediatricians increased in Japan between 1996 and 2004; however, they were mal-distributed in rural areas, suggesting that non-pediatricians in pediatric practice have played a significant role in supporting pediatric care in Rural areas.
Health PolicyPhysician scarcity is a predictor of further scarcity in US, and a predictor of concentration in Japan
20 Citations2009Masatoshi Matsumoto, Kazuo Inoue +3 more
Competition-based physician diffusion strategies and various interventions to address the maldistribution of physicians apparently have not worked effectively in US compared with Japan, while scarcity is associated with recovery from scarcity in Japanese communities.
Medical CareThe Relationship Between Commuting Patterns and Health Resources in Nonmetropolitan Counties of the United States
9 Citations1992Hong Wang, David A. Kindig
PubMed[Geographic distribution of medical supplies and the numbers of hospital inpatients in the secondary medical areas in Japan].
8 Citations1997Shinichi Tanihara, T Zhang +4 more
The main results were that the distribution of physicians and general hospital beds among the secondary medical areas was not equal and the differences in hospital inpatients/population ratio may be caused by differences in medical supplies.
Nippon Eiseigaku Zasshi (Japanese Journal of Hygiene)Chronological Analysis of Disparities in Numbers of Ordinary Hospital Beds and X-Ray Computed Tomography Scanners among Secondary Medical Care Sectors
3 Citations2006Kazuaki Miyagishima, Takeshi Kawaguchi
The disparities in medical care resources among SMCSs decreased for ordinary hospital beds more markedly than for X-ray CT scanners, possibly as an effect of the implementation of the Medical Care Plan.