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ID 48631
file
creator
Inoue, Kazuo
Takeuchi, Keisuke
subject
geographic information systems
geography
manpower
medically underserved area
physicians
rural Japan
supply and distribution
abstract
Introduction: Although some characteristics of physicians are known to be associated with their recruitment in rural and remote areas, the factors that predict mobility of physicians, and in particular, their mobility to rural and distant areas are largely unknown.
Methods: Flows of all physicians (n=4268) among municipalities in Hiroshima Prefecture, Japan, between 2002 and 2008 were analysed. Physician data were obtained from the National Physician Census. Municipality-level population data derived from the National Basic Resident Register were merged with the physician data. Information on the road distances of two municipalities measured with a geographic information system (GIS) was added to the physician cohort.
Results: During the period of study, 24.8% of physicians crossed municipal borders, and among them, 66.6% moved distances of less than 60 min travel time. The number of migrated physicians decreased as the distance increased, which held true for both migration to urban and rural areas. In the univariate analysis, female, younger, and hospital physicians were more mobile to rural areas than were male, older, and clinic physicians. Male and younger (≤40 years) physicians moved a longer distance than female and older physicians. Multivariate analysis revealed that age was a negative predictor (odds ratio [OR] per 10 years 0.62, 95% confidence interval [CI] 0.55-0.70]), and affiliation with a hospital was a positive predictor of migration to rural areas (OR 6.19 [95% CI 4.21-9.10]). Male sex (OR 1.67 [95% CI 1.11-2.50]) and hospital affiliation (OR 5.61 [95% CI 3.33-9.45]) were positive predictors, and age (OR per 10 years 0.39 [95% CI 0.33-0.46]) was a negative predictor of migrating a long distance.
Conclusion: In order to attract physicians to rural and remote areas, health workforce policies need to set a target population of physicians who are highly mobile to such places. Combining known predictors of rural practice, such as physicians with rural background and primary care physicians, and the mobility predictors shown in this study (ie young, hospital and male physicians) would make the target more appropriate and policies more effective.
description
The Ministry of Education, Culture, Sports, Science and Technology (Tokyo, Japan) and Satake Education and Research Fund (Hiroshima, Japan) sponsored this research.
journal title
Rural and Remote Health
volume
Volume 12
issue
Issue 2
start page
2027
date of issued
2012-05-11
publisher
James Cook University
issn
1445-6354
pubmed id
language
eng
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
publisher
rights
© M Matsumoto, K Inoue, S Kashima, K Takeuchi, 2012. A licence to publish this material has been given to James Cook University, http://www.rrh.org.au
relation url
department
Graduate School of Biomedical & Health Sciences



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