Tomiyama Masahiko
Stroke Unit and Department of Neurology, Aomori Prefectural Central Hospital.
Rinsho Shinkeigaku. 2010 Nov;50(11):1063-5. doi: 10.5692/clinicalneurol.50.1063.
The population and the area of Aomori prefecture are 1,380 thousands and 9,644 km2, respectively. Aomori prefecture geographically and economically forms an independent medical district. However, only 29 neurological specialists attended work in Aomori Prefecture. The numbers of neurological specialists per 100,000 people and per 100 km(2) were 2.1 and 0.3 in Aomori, respectively, whereas those of Tokyo metropolitan area were 5.9 and 34.9, and their nationwide averages were 3.6 and 1.2, respectively. Although Aomori prefecture is divided into six medical service areas, neurologists were eccentrically-located in three cities; Aomori, Hirosaki and Hachinohe. No neurologists give full-time service in three of the six areas. The percentage of people having medical care certificate for six specified neurological disorders (multiple sclerosis, myasthenia gravis, amyotrophic lateral sclerosis, spinocerebellar degeneration, Parkinson disease and related disorders, and multisystem atrophy) in Aomori was comparable to the nationwide average. However, the number of patients with the certificate of multiple sclerosis and myasthenia gravis in areas with neurologist's service were 11.4 and 12.0 per 100,000 people, respectively, whereas those of area without full-time neurologist's service were 9.9 and 9.2, (significant lower). The patients living in the area without neurologist's service received medical care by neurologists less frequently when compared to those living in area with neurologist's service. Forty-five percent of the patients living in the area without neurologist's service went out of their living areas to see neurologists regularly. Thus, neurologists in Aomori prefecture are under strain to provide medical services. People in Aomori prefecture do not receive sufficient neurological services, especially in the area where no neurologists attend work. In addition, patients living in area without neurologist's service bear greater burden to go to hospital.
青森县的人口和面积分别为138万和9644平方公里。青森县在地理和经济上形成了一个独立的医疗区。然而，青森县只有29名神经科专家在职。青森县每10万人和每100平方公里的神经科专家数量分别为2.1人和0.3人，而东京都市区分别为5.9人和34.9人，全国平均水平分别为3.6人和1.2人。虽然青森县分为六个医疗服务区，但神经科医生集中在三个城市：青森、弘前和八户。六个区域中有三个没有神经科医生提供全职服务。青森县患有六种特定神经系统疾病（多发性硬化症、重症肌无力、肌萎缩侧索硬化症、脊髓小脑变性、帕金森病及相关疾病、多系统萎缩）医疗护理证书的人口比例与全国平均水平相当。然而，有神经科医生服务地区的多发性硬化症和重症肌无力患者证书数量分别为每10万人11.4人和12.0人，而没有神经科医生全职服务地区的这一数量为9.9人和9.2人（显著较低）。与有神经科医生服务地区的患者相比，生活在没有神经科医生服务地区的患者接受神经科医生治疗的频率较低。生活在没有神经科医生服务地区的患者中有45%定期前往其他地区看神经科医生。因此，青森县的神经科医生提供医疗服务面临压力。青森县的居民没有得到足够的神经科服务，尤其是在没有神经科医生工作的地区。此外，生活在没有神经科医生服务地区的患者前往医院的负担更大。
