Perceptions of Residents among Rural Communities with Medical Group Practice in Japan

Toshie Manabe, Tsutomu Sawada, Takao Kojo, Seitaro Iguchi, Sanae Haruyama, Takahiro Maeda and Kazuhiko Kotani
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Toshie Manabe: Division of Community and Family Medicine, Center of Community Medicine, Jichi Medical University, Shimotsuke-City, Tochigi 329-0498, Japan
Tsutomu Sawada: Kochi Health Sciences Center, Kochi 781-8555, Japan
Takao Kojo: Department of Health Management, School of Health Studies, Tokai University, Kanagawa 252-0331, Japan
Seitaro Iguchi: Department of Community Medicine, Niigata University Graduate School of Medicine and Dental Sciences, Niigata 951-8122, Japan
Sanae Haruyama: Faculty of Nursing, Jichi Medical University, Tochigi 329-0498, Japan
Takahiro Maeda: Department of General Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8523, Japan
Kazuhiko Kotani: Division of Community and Family Medicine, Center of Community Medicine, Jichi Medical University, Shimotsuke-City, Tochigi 329-0498, Japan

IJERPH, 2019, vol. 16, issue 24, 1-8

Abstract: Elucidating the perceptions of residents regarding medical group practice (GP) among rural communities (GP-R) in Japan will be useful for establishing this system in such communities. A survey by questionnaire, as made by experts in rural health, was conducted in 2017. The self-administered questionnaire inquired about the perceptions of residents for accepting the GP-R into the community’s healthcare using seven major elements of GP-R. The questionnaire was randomly distributed to 400 adult residents who lived in rural communities with a recently launched GP and had access to clinics within the communities. Among the 321 respondents, comparisons were made between younger (≤sixties) and older (≥seventies) residents, and a stepwise multiple regression analysis was performed to extract the factors influencing acceptance of the GP-R system. The results showed that older residents had a greater disapprove of being treated by different physicians daily or weekly in clinics ( p < 0.001) and the use of telemedicine ( p < 0.001) compared with younger residents. Younger residents showed a greater disapproval of clinics closing on weekdays than older residents ( p = 0.007). Among all respondents, regardless of age groups, over half of residents approved of the involvement of nurse practitioners in the GP-R. Living with family and children was also extracted as an independent factor influencing a positive perception of the GP-R. These data suggest that the promotion of GP-R should consider generation gaps in the approach to medical practice as well as the family structures of residents. The involvement of nurse practitioners can also encourage the acceptance of GP-R in Japan.

Keywords: rural health; physician shortage; nurse practitioner; remote consultation; family structure (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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