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ID 48631
本文ファイル
著者
Inoue, Kazuo
Kashima, Saori 大学院医歯薬保健学研究院 広大研究者総覧
Takeuchi, Keisuke 医学部
キーワード
geographic information systems
geography
manpower
medically underserved area
physicians
rural Japan
supply and distribution
抄録(英)
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.
内容記述
The Ministry of Education, Culture, Sports, Science and Technology (Tokyo, Japan) and Satake Education and Research Fund (Hiroshima, Japan) sponsored this research.
掲載誌名
Rural and Remote Health
12巻
2号
開始ページ
2027
出版年月日
2012-05-11
出版者
James Cook University
ISSN
1445-6354
PubMedID
言語
英語
NII資源タイプ
学術雑誌論文
広大資料タイプ
学術雑誌論文
DCMIタイプ
text
フォーマット
application/pdf
著者版フラグ
publisher
権利情報
© 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
関連情報URL
部局名
医歯薬保健学研究科