Has the new postgraduate education for physicians improved their distribution?

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K09145
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Hygiene and public health
• Research Institution: Teikyo University
• Principal Investigator: Inoue Kazuo 帝京大学, 医学部, 教授 (70275709)
• Co-Investigator(Kenkyū-buntansha): 鹿嶋 小緒里 広島大学, 国際協力研究科, 准教授 (30581699) ; 松本 正俊 広島大学, 医系科学研究科(医), 寄附講座教授 (40348016)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 医師分布 / 新臨床医師研修制度 / 市町村分析 / 縦断分析 / ギニ係数

Outline of Final Research Achievements

Methods: We analyzed the distribution of physicians in municipalities at three time points: 1994, 2004 and 2014. The Lorenz curve and Gini coefficient were calculated by accumulating the number of doctors according to the population of each municipality, and the distribution was evaluated.
Results:(1) The distribution improved from 1994 to 2004, but remained unchanged from 2004 to 2014. (2)In the analysis by physician experience, the groups of middle-aged and older physicians were more evenly distributed than younger physicians. (3)The Gini coefficients of female physicians were higher than that of male physicians in all age groups, and the shortage of female physicians was particularly remarkable in small populated municipalities.
Conclusion: We quantitatively showed the deterioration of doctor distribution after the start of the new postgraduate clinical training system for physicians. In addition, the distribution difference between male and female physicians was remarkable.

Free Research Field

地域医療学

Academic Significance and Societal Importance of the Research Achievements

2004年に開始された新臨床医師研修制度については、医師のプライマリ・ケア能力の向上に貢献したとされる一方、へき地などの医師分布を悪化させたと言われている。しかしながら定量的な知見に乏しく、本研究はそれを明らかにした。
したがって、臨床研修の実施にあたっては、医師分布を悪化させないために、へき地などに留意してプログラムを組む必要がある。また、特性別では性別（男性か女性医師か）による差が大きい。これも将来にわたる留意点となるであろう。