Cheng Feng-Chou, Chang Julia Yu-Fong, Lin Tzu-Chiang, Tsai Po-Fang, Chang Yung-Ta, Chiang Chun-Pin
School of Life Science, National Taiwan Normal University, Taipei, Taiwan.
Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
J Dent Sci. 2020 Dec;15(4):542-549. doi: 10.1016/j.jds.2020.08.009. Epub 2020 Sep 1.
BACKGROUND/PURPOSE: Taiwan implemented the non-compulsory postgraduate year training program for dentists (PGYD) in 2010. Previous studies found that training institutions for dentists are mostly distributed in metropolitan areas. This study explored whether the PGYD system might worsen the imbalance of geographical distribution of dentists in Taiwan.
This study collected the data of population, the number of practicing dentists from 2010 to 2018, and the number of practicing dentists in the training institutions in 2018 to draw the Lorenz curve and to calculate the Gini coefficient for evaluating whether the PGYD system might worsen the imbalance of geographical distribution of dentists in Taiwan.
Our results showed that the uneven geographical distribution of overall practicing dentists did not deteriorate after the implementation of the PGYD system. However, the uneven geographical distribution of practicing dentists in training institutions was more serious than the uneven geographical distribution of overall practicing dentists.
Because the PGYD system is not mandatory, dentists engage in training program and select training institutions as driven by the market factors. After completion of the PGYD training, dentists choose the practice location as driven by the market factors again and this in turn redistributes the dentists to different regions of Taiwan. In addition, major dentist policies may also result in the movement of dentists to various regions of Taiwan. Thus, the market-driven redistribution of dentists to different regions of Taiwan finally reduces the imbalance of geographical distribution of dentists in Taiwan caused by the PGYD system.
背景/目的：台湾于2010年实施了非强制性的牙医研究生培训项目（PGYD）。先前的研究发现，牙医培训机构大多分布在大都市地区。本研究探讨了PGYD系统是否可能加剧台湾牙医地理分布的不平衡。
本研究收集了2010年至2018年的人口数据、执业牙医数量以及2018年培训机构中的执业牙医数量，绘制洛伦兹曲线并计算基尼系数，以评估PGYD系统是否可能加剧台湾牙医地理分布的不平衡。
我们的结果表明，PGYD系统实施后，整体执业牙医的地理分布不均并未恶化。然而，培训机构中执业牙医的地理分布不均比整体执业牙医的地理分布不均更为严重。
由于PGYD系统不是强制性的，牙医参与培训项目并选择培训机构是受市场因素驱动。PGYD培训完成后，牙医再次受市场因素驱动选择执业地点，这反过来又将牙医重新分配到台湾的不同地区。此外，主要的牙医政策也可能导致牙医向台湾的各个地区流动。因此，市场驱动的牙医向台湾不同地区的重新分配最终减少了PGYD系统导致的台湾牙医地理分布不平衡。
