Forecasting the regional distribution and sufficiency of physicians in Japan with a coupled system dynamics—geographic information system model

Human Resources for Health

Research

Hisateru Ohba¹  Teppei Suzuki²  Katsuhiko Ogasawara²  Kensuke Fujiwara³  Tomoki Ishikawa⁴ 

[1] Department of Radiological Technology, Faculty of Health Sciences, Hokkaido University of Science, 7-Jo 15-4-1, Maeda, Teine-ku, 006-8585, Sapporo, Japan;Faculty of Health Sciences, Hokkaido University, N12W5, Kita-ku, 060-0812, Sapporo, Japan;Graduate School of Health Sciences, Hokkaido University, N12W5, Kita-ku, 060-0812, Sapporo, Japan;Graduate School of Health Sciences, Hokkaido University, N12W5, Kita-ku, 060-0812, Sapporo, Japan;Faculty of Health Sciences, Hokkaido University, N12W5, Kita-ku, 060-0812, Sapporo, Japan;

关键词: Forecasting;    Physicians;    Physician shortage;    Maldistribution;    System dynamics;   

DOI  :  10.1186/s12960-017-0238-8

 received in 2016-08-15, accepted in 2017-09-04,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn Japan, the shortage of physicians has been recognized as a major medical issue. In our previous study, we reported that the absolute shortage will be resolved in the long term, but maldistribution among specialties will persist. To address regional shortage, several Japanese medical schools increased existing quota and established “regional quotas.” This study aims to assist policy makers in designing effective policies; we built a model for forecasting physician numbers by region to evaluate future physician supply–demand balances.MethodsFor our case study, we selected Hokkaido Prefecture in Japan, a region displaying disparities in healthcare services availability between urban and rural areas. We combined a system dynamics (SD) model with geographic information system (GIS) technology to analyze the dynamic change in spatial distribution of indicators. For Hokkaido overall and for each secondary medical service area (SMSA) within the prefecture, we analyzed the total number of practicing physicians. For evaluating absolute shortage and maldistribution, we calculated sufficiency levels and Gini coefficient. Our study covered the period 2010–2030 in 5-year increments.ResultsAccording to our forecast, physician shortage in Hokkaido Prefecture will largely be resolved by 2020. Based on current policies, we forecast that four SMSAs in Hokkaido will continue to experience physician shortages past that date, but only one SMSA would still be understaffed in 2030.ConclusionThe results show the possibility that diminishing imbalances between SMSAs would not necessarily mean that regional maldistribution would be eliminated, as seen from the sufficiency levels of the various SMSAs. Urgent steps should be taken to place doctors in areas where our forecasting model predicts that physician shortages could occur in the future.

【 授权许可】

CC BY   
© The Author(s). 2017

【 图 表 】

Fig. 6