Ishikawa Masatoshi
Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, USA.
Cureus. 2022 Jan 17;14(1):e21321. doi: 10.7759/cureus.21321. eCollection 2022 Jan.
Background and objective In Japan, clinics play a key role in providing primary medical care. Data on temporal trends in the number, proportion, and characteristics of clinical physicians, as well as factors associated with the opening of clinics in Japan, have not been adequately explored. This study aimed to analyze the temporal trends as well as factors associated with the opening of clinics in Japan. Methodology This study employed a longitudinal study design. Data from the biennial national physician census surveys from 1996 to 2016 were analyzed. It involved all physicians in Japan. As the primary and secondary outcome measures, temporal trends in the number and percentages of physicians were estimated and logistic regression was used to analyze physicians opening clinics. Results Recently, the rate of increase in the number of clinical physicians in Japan has been decelerating, and the proportion of older clinical physicians has been increasing. Specifically, the number of clinical physicians increased in the first decade, from 81,888 in 1996 to 95,213 in 2006, but decreased in the second decade to 102,453 in 2016. Apparently, clinical physicians were aging: the number of clinical physicians aged 39 years or younger decreased by 48%, while those aged between 55 and 69 years increased by 91%. The physician-related factors associated with opening clinics include belonging to the age group of 40-54 years, being male, and having an urban area to practice. As of 2016, 39.1% held no board-certified qualifications, whereas 17.1% held board-certified qualifications in areas other than their specialization. Conclusion This study based on national surveys revealed that the rate of increase in doctors in Japanese clinics is slowing down and that the proportion of elderly doctors is increasing. The physician-related factors associated with opening clinics include being middle-aged, male gender, and the availability of an urban area for practice.
背景与目的 在日本，诊所是提供初级医疗服务的关键机构。目前尚未充分探究日本临床医生数量、比例及特征的时间趋势，以及与诊所开业相关的因素。本研究旨在分析日本诊所开业的时间趋势及相关因素。
方法 本研究采用纵向研究设计。分析了1996年至2016年每两年进行一次的全国医生普查数据。研究对象为日本所有医生。作为主要和次要结局指标，估计了医生数量和百分比的时间趋势，并采用逻辑回归分析医生开设诊所的情况。
结果 近年来，日本临床医生数量的增长率一直在放缓，老年临床医生的比例在增加。具体而言，临床医生数量在第一个十年中有所增加，从1996年的81888人增加到2006年的95213人，但在第二个十年中有所下降，到2016年降至102453人。显然，临床医生正在老龄化：39岁及以下的临床医生数量减少了48%，而55至69岁的临床医生数量增加了91%。与开设诊所相关的医生因素包括年龄在40-54岁之间、男性以及有城市地区可供执业。截至2016年，39.1%的医生没有获得委员会认证资格，而17.1%的医生在其专业领域以外获得了委员会认证资格。
结论 这项基于全国调查的研究表明，日本诊所医生数量的增长率正在放缓，老年医生的比例在增加。与开设诊所相关的医生因素包括中年、男性以及有城市地区可供执业。
