Crisis Management Office, Niigata University Medical and Dental Hospital, Asahimachi-Dori1-754, Chuo-Ku, Niigata City 951-8520, Japan.
Int J Equity Health. 2009 Mar 3;8:5. doi: 10.1186/1475-9276-8-5.
Since the late 1980s, the policy of the Japanese government regarding physician manpower has been to decrease the number of medical students. However, the shortage of doctors in Japan has become a social problem in recent years. The aim of this study was to compare the numbers of physicians in Japan between 1996 and 2006 and the trends in distribution of physicians.
The time trends in number and distribution of physicians between 1996 and 2006 were analyzed. Gini coefficient, Atkinson index and Theil index were used as measures for mal-distribution of physicians to population. The distribution of physicians was visualized on a map by using geographic information system (GIS) software.
The total number of physicians increased every year in the period from 1996 to 2006 but has remained below the international standard. All three measures of mal-distribution of physicians worsened after 2004, and the worsening was remarkable in the distribution of physicians working at hospitals. The number of physicians working at hospitals has significantly increased in urban areas but not in areas with low population densities. When medical interns were excluded from calculation, the measures of mal-distribution improved.
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. The new postgraduate internship system might worsen this situation.
自 20 世纪 80 年代末以来，日本政府的医师人力政策一直是减少医学生的数量。然而，近年来日本医生短缺已成为一个社会问题。本研究旨在比较 1996 年至 2006 年日本医生的数量和分布趋势。
分析了 1996 年至 2006 年期间医生数量和分布的时间趋势。基尼系数、阿特金森指数和泰尔指数被用作衡量医生对人口分布不均的指标。使用地理信息系统（GIS）软件在地图上可视化医生的分布。
1996 年至 2006 年期间，医生总数每年都在增加，但仍低于国际标准。2004 年后，所有三种衡量医生分布不均的指标都恶化了，医院医生的分布恶化更为显著。医院工作的医生人数在城市地区显著增加，但在人口密度较低的地区则没有增加。当将实习医生从计算中排除时，分布不均的衡量指标有所改善。
日本的医生短缺问题与医生数量的绝对短缺和医院医生的分布不均有关。新的研究生实习制度可能会使这种情况恶化。
