Association Between Child Welfare Facilities and Distribution of Doctors in Japan: An Observational Study

Introduction Child welfare facilities (CWFs) may be crucial in determining the distribution of doctors. However, research investigating the relationship between the CWFs and the distribution of doctors in Japan is limited. Therefore, this study examined the relationship between the CWFs and the distribution of doctors across secondary medical areas in Japan. Methods The study considered secondary medical areas in the Kinki and Chugoku regions. The change in the number of CWFs was represented by four categorical variables (0 or fewer, 1-4, 5-9, and 10 or more). The distribution of doctors was defined as the adjusted number of doctors per 100,000 people and was represented by three categorical variables and a continuous variable. We used ordinal logistic and linear regression analyses to assess the association between the change in the number of CWFs and the adjusted number of doctors per 100,000 people, after adjusting for medical expense subsidies for infants, retail sales floor area per population, income per taxpayer, and hours of sunlight. Results Across 71 secondary medical areas in Japan, a statistically significant association was observed between the group with an increase of 10 or more CWFs and the adjusted number of doctors per 100,000 people (odds ratio: 5.1; 95% confidence interval: 1.02 to 25.8). Additionally, this group had an increased adjusted number of doctors per 100,000 people, which was more than 50 higher than that of the group with no increase in CWFs. Conclusion These findings suggest that there may be an association between increasing CWFs and the adjusted number of doctors per 100,000 people.