Department of Social Medicine, Toho University School of Medicine, Tokyo, Japan.
Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Tokyo, Japan.
PLoS One. 2021 Jan 12;16(1):e0245385. doi: 10.1371/journal.pone.0245385. eCollection 2021.
In Japan, there is a large geographical maldistribution of obstetricians/gynecologists, with a high proportion of females. This study seeks to clarify how the increase in the proportion of female physicians affects the geographical maldistribution of obstetrics/gynecologists.
Governmental data of the Survey of Physicians, Dentists and Pharmacists between 1996 and 2016 were used. The Gini coefficient was used to measure the geographical maldistribution. We divided obstetricians/gynecologists into four groups based on age and gender: males under 40 years, females under 40 years, males aged 40 years and above, and females aged 40 years and above, and the time trend of the maldistribution and contribution of each group was evaluated.
The maldistribution of obstetricians/gynecologists was found to be worse during the study period, with the Gini coefficient exceeding 0.400 in 2016. The contribution ratios of female physicians to the deterioration of geographical maldistribution have been increasing for those under 40 years and those aged 40 years and above. However, there was a continuous decrease in the Gini coefficient of the two groups.
The increase in the contribution ratio of the female physician groups to the Gini coefficient in obstetrics/gynecology may be due to the increased weight of these groups. The Gini coefficients of the female groups were also found to be on a decline. Although this may be because the working environment for female physicians improved or more female physicians established their practice in previously underserved areas, such a notion needs to be investigated in a follow-up study.
在日本，妇产科医生的地理分布不均，女性比例较高。本研究旨在阐明女性医生比例的增加如何影响妇产科医生的地理分布不均。
使用了 1996 年至 2016 年期间的医师、牙医和药剂师调查的政府数据。基尼系数用于衡量地理分布不均。我们根据年龄和性别将妇产科医生分为四组：40 岁以下的男性、40 岁以下的女性、40 岁及以上的男性和 40 岁及以上的女性，并评估了每个组别的分布不均和贡献的时间趋势。
研究期间发现妇产科医生的分布不均情况恶化，基尼系数在 2016 年超过 0.400。40 岁以下和 40 岁及以上的女性医生对地理分布不均恶化的贡献比例一直在增加。然而，这两个组别的基尼系数却持续下降。
妇产科中女性医生群体对基尼系数的贡献比例增加可能是由于这些群体的权重增加所致。女性群体的基尼系数也呈下降趋势。尽管这可能是因为女性医生的工作环境得到改善，或者更多的女性医生在以前服务不足的地区开展业务，但需要在后续研究中对此进行调查。
