| Budget Amount *help |
¥2,990,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥690,000)
Fiscal Year 2010: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2009: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
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| Research Abstract |
Employing a multi-dimensional policy evaluation framework which consists of "context level" and "social level" evaluations, the New Resident Training Policy in Japan is analyzed in this research. At the context level, the new policy has achieved its two objectives, training resident's ability of primary care and improving their pay and working conditions, to some extent, and those objectives are agreed on by all stakeholders at the context level based on their values on expertise and autonomy. At the social level, the new policy actually triggered the maldistribution of doctor over areas, specialties and types of facility, which had not been expected nor intended. As the new policy involves an allowance for the private nature of doctor, it has eventually damaged the "equal" system, while it had been intended to contribute to the "equal" healthcare system, which could be favorably evaluated. "Matching System" of the new policy involves the value on the private nature of doctor and triggered the maldistribution of doctor. It could thus be analyzed that the new policy has desirable objectives at the context level but it involves undesirable influences, which should have been estimated and solved before its enforcement, at the social level. The recent "solutions" are not enough, or even inappropriate, since those "solutions" do not solve the fundamental value conflict between the private and public natures of doctor and may result in other unintended problems in future. In order to solve the maldistribution of doctor, a policy which is intended to contribute to "equal" healthcare system by putting more emphasis on the public nature of doctor should be considered.
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