The Institute for Medical Governance, a non-profit organization, estimated the movement of doctors by prefecture using materials published by the Ministry of Health, Labor and Welfare.As a result, there is a prefectural disparity of up to 313% in choosing a doctor's place of work, and 68% of doctors from the medical school in each region in Ishikawa Prefecture and 13% in Tokyo have flowed out to other regions. all right.
The number of Japanese doctors increased from 1961 in 10 (about 10 per 104 population) to 2016 in 32 (about 10 per 240 population).However, the shortage of doctors is still serious in some areas, and the disparity in medical resources between prefectures has not narrowed.
Looking at the number of doctors per 10 population by prefecture, Tokushima prefecture (315.9) and Kyoto prefecture (314.9) are ranked high, and Saitama prefecture (160.1) and Ibaraki prefecture (180.4) are ranked low. ..
In Japan, doctors are almost free to choose their place of work, but after graduating from medical school, there is no data that gives specific figures on where doctors work, and it remains unclear about the movement of doctors. was.Therefore, the research team analyzed the public data * of the Ministry of Health, Labor and Welfare from 1995 to 2014, and estimated the apparent movement rate of doctors from the difference between the number of doctors trained and the number of working doctors by prefecture.
As a result of the survey, the largest outflow of doctors was in Ishikawa prefecture, where 68% of postgraduate doctors had moved to other prefectures.On the contrary, the largest inflow was in Chiba prefecture, where 245% of postgraduate doctors had moved from other prefectures.The outflow of doctors was large in Ishikawa, Shimane, and Kochi prefectures, and the inflow was large in the suburbs of metropolitan areas, Chiba, Saitama, and Shizuoka prefectures.On the other hand, in the big city of Tokyo, 13% of doctors flowed out, and in Aichi, Osaka, and Fukuoka prefectures, doctors flowed in the range of 7.7% to .8%.
It was found that the prefectures where doctors are flowing in tend to have less admission slots for medical schools per capita, and the prefectures where doctors are flowing out tend to have more admission slots for medical schools.It is thought that this is because doctors in prefectures with a large number of medical school admissions can easily go to other areas.In the case of Tokyo, there are 13 medical schools, and the number of medical school admissions per capita is relatively large, so it can be said that this is outflowing.In Chiba prefecture near Tokyo, more than twice the number of doctors trained is flowing in from other prefectures, but the number of doctors per 2 population is still very small (Chiba: 10).
The research team points out that the movement of doctors between prefectures has a large effect on the uneven distribution of doctors throughout Japan, and it will be one of the important viewpoints when considering future medical policies.
* The public data used is the number of doctors trained by prefecture from the number of doctors by prefecture from the survey of doctors, dentists, and pharmacists, and the number of doctors who passed the national examination for doctors by each medical school, using the materials released by the Ministry of Health, Labor and Welfare.Population data uses population data based on the Basic Resident Register.
Paper information:[Medicine A model-based estimation of inter-prefectural migration of physicians within Japan and associated factors: A 20-year retrospective study
