Dispatch of locum doctors to rural clinics on remote islands in Japan

Objective: The dispatch of a locum doctor (DLD) system is an important aspect of the clinical settings in remote islands, where securing doctors is a major challenge. This study investigated the conditions associated with DLD requests and observed an association between DLD requests and several regional factors in rural clinics on remote islands in Japan. Materials and Methods: Questionnaires regarding DLD requests were mailed to all rural clinics on remote islands managed under the rural plans of the prefectural governments of Japan in December 2022. The regional factors assessed included population size (large remote islands: population ≥1,000 people), doctor staffing on islands (single or multiple doctors within an island), and distance between rural clinics and the nearest core hospitals, which are designated at the prefectural level of Japan to support and collaborate with rural clinics (long distance, ≥25 km). The association between DLD requests and regional characteristics was analyzed with and without DLD requests. Results: Of the 72 rural clinics (32%) that responded completely to the questionnaire, 27 (38%) had made DLD requests. In the logistic regression analysis, DLD requests were positively associated with long distances from core hospitals (odds ratio [OR]=3.82, 95% confidence interval [CI]: 1.26-11.6) and the presence of a single doctor on the island (OR=5.24, 95% CI: 1.73-15.9). Conclusion: These results indicate that DLD requests may be more frequent from remote islands, which were far from core hospitals, and those staffed by a single doctor. Measures based on these results may contribute to the development of efficient medical support systems for remote islands in Japan.