Geographic distribution of physicians in Japan.

Area of Science:

• Health Policy
• Medical Workforce
• Public Health

Background:

• Japan faced doctor shortages and maldistribution in the 1970s.
• A policy was enacted to increase medical student and school numbers.
• This policy aimed to address physician supply issues.

Purpose of the Study:

• To evaluate the success of Japan's physician manpower policy.
• To analyze physician distribution changes between 1980 and 1990.
• To assess the policy's impact on physician maldistribution.

Main Methods:

• Analysis of physician numbers relative to population across all Japanese municipal bodies (n=3268).
• Utilized Lorenz curve and Gini coefficient to assess distribution inequality.
• Compared physician distribution in areas with populations over 30,000 versus under 10,000.

Main Results:

• The number of practicing physicians increased by 37% nationally.
• Physician ratio per 100,000 population rose from 127 to 165.
• Physician distribution inequality persisted, with larger communities gaining more physicians.

Conclusions:

• Despite increasing physician numbers, the policy did not resolve maldistribution.
• Smaller communities received disproportionately fewer physicians.
• New policies are needed to effectively address physician maldistribution in Japan.