Evidence map›Paper›PMID 29851805›Full record

ArticleMedicine2018

A model-based estimation of inter-prefectural migration of physicians within Japan and associated factors: A 20-year retrospective study.

Naoki Okada, Tetsuya Tanimoto, Tomohiro Morita, Asaka Higuchi, Izumi Yoshida, Kazuhiro Kosugi, Yuto Maeda, Yoshitaka Nishikawa, Akihiko Ozaki, Kenji Tsuda and 6 more

Abstract read
In one paragraph

Article in Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

16 authors.

Naoki OkadaKeio University Navitas Clinic, Tokyo Jyoban Hospital of Tokiwa Foundation Soma Central Hospital, Fukushima Medical Governance Research Institute, Tokyo National Cancer Center Hospital East, Chiba National Center for Child Health and Development, Tokyo Kyoto University, Kyoto Ohmachi Hospital, Fukushima Graduate School of Public Health, Teikyo University, Tokyo Kanagawa Cancer Center, Kanagawa Institute of Medical Sciences, University of Tokyo, Tokyo, Japan.
Tetsuya Tanimoto
Tomohiro Morita
Asaka Higuchi
Izumi Yoshida
Kazuhiro Kosugi
Yuto Maeda
Yoshitaka Nishikawa
Akihiko Ozaki
Kenji Tsuda
Jinichi Mori
Mutsuko Ohnishi
Larry Wesley Ward
Hiroto Narimatsu
Koichiro Yuji
Masahiro Kami

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Despite an increase in the number of physicians in Japan, misdistribution of physicians within the 47 prefectures remains a major issue. Migration of physicians among prefectures might partly explain the misdistribution. However, geographical differences and the magnitude of physicians' migration are unclear. The aim of this study was to estimate the extent of migration of physicians among prefectures and explore possible factors associated with physicians' migration patterns.Using a publicly available government database from 1995 to 2014, a quantitative estimation of physicians' migration after graduation from a medical school was performed. The inflow and outflow of physicians were ostensibly calculated in each prefecture based on the differences between the number of newly licensed physicians and the actual number of practicing physicians after an adjustment for the number of deceased or retired physicians. Simple and multiple linear regression analyses were conducted to examine socio-demographic background factors.During the 20-year study period, the mean annual numbers of newly licensed physicians, deceased or retired physicians, and increase in practicing physicians in the whole country were 7416, 3382, and 4034, respectively. Among the 47 prefectures, the median annual number of newly licensed physicians to 100,000 population ratio (PPR) was 6.4 (range 1.5-16.5), the median annual adjusted number of newly licensed physicians was 61 (range, -18 to 845; the negative and positive values denote outflow and inflow, respectively), whereas the median annual number of migrating physicians was 13 (range, -171 to 241). The minimum and maximum migration ratios observed were -68% and 245%, respectively. In the final regression model of the 8 variables examined, only "newly licensed PPR" remained significantly associated with physician's migration ratios.A significant inequality in the proportion of the migration of physicians among prefectures in Japan was observed. The multivariate analyses suggest that the newly licensed PPRs, and not from-rural-to-urban migration, might be one of the keys to explaining the migration ratios of physicians. The differences and magnitude of physicians' migration should be factored into mitigate misdistribution of physicians.

Indexed as

Statistics as TopicAdultDatabases, FactualFemaleHumansJapanLicensure, MedicalMaleMiddle AgedMultivariate AnalysisPhysiciansPopulation DynamicsRegression AnalysisRetrospective Studies

Identifiers

PMID29851805
PMCPMC6392712

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.