ArticleBMJ open2020
Temporal trends of physician geographical distribution and high and intermediate physician density areas and factors related to physicians' movement to low physician density areas in Japan: a longitudinal study (1996-2016).
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 18 citations in OpenAlex.
- Association between rurality and mortality from major diseases in Japan: an ecological study.BMJ open · 2026Article
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- Regional Disparities in Hyperacute Treatment and Functional Outcomes after Acute Ischemic Stroke in Japan.Journal of atherosclerosis and thrombosis · 2024Article
- Factors related to the resignation and migration of physicians in public health administration agencies using nationwide survey data in Japan.BMC health services research · 2023Article
- Regional assessment of medical care provision system by principal component analysis.Journal of family medicine and primary care · 2023Article
- Factors related to Japanese internal medicine doctors' retention or migration to rural areas: a nationwide retrospective cohort study.Environmental health and preventive medicine · 2023Article
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Authors and funding
1 author at 1 institution in 2 countries.
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Abstract
objectivesA major issue in Japan's health policy is the geographical maldistribution of physicians. This study aimed to analyse temporal trends in the geographical distribution of physicians and analyse physicians in high and intermediate physician density areas and factors related to their movement to low physician density areas in Japan.
designA longitudinal study.
settingAll physicians in 344 secondary medical districts.
participantsI analysed data from the biennial national census, conducted by the Ministry of Health, Labour and Welfare between 1996 and 2016 and and divided it into two cohorts of 10 years each: 1996-2006 and 2006-2016. PRIMARY AND SECONDARY OUTCOME MEASURES: I estimated the temporal trends in the number and percentages of physicians, and used logistic regression to analyse physicians in high and intermediate physician density areas and the factors related to their movement to low physician density areas.
resultsThe overall number of Japanese doctors increased by 31% between 1996 and 2016. The number of physicians per population in the physician high-density areas increased by 29%, while those in low-density areas increased by 32%, suggesting that the gap between areas marginally decreased. The multivariable logistic regression analyses revealed that academic hospital experience had the highest OR for predicting physician movement to low physician density areas after 10 years, both in the 1996 and 2006 cohorts. Other factors that positively correlated with physician movement were being male, being younger than 40 years, being qualified after the age of 30, urban area, intermediate physician density area and practice in a non-academic hospital.
conclusionsAs less-experienced physicians demonstrate high mobility among geographic categories, and retention rates are low in low physician density areas, especially for less-experienced physicians, a new system that considers these factors would create opportunities for younger physicians to work in low-density areas.
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