Physician scarcity is a predictor of further scarcity in US, and a predictor of concentration in Japan

Masatoshi Matsumoto, Kazuo Inoue, Robert Bowman, Satomi Noguchi and Eiji Kajii

Health Policy, 2010, vol. 95, issue 2-3, 129-136

Abstract: Objectives To assess the effects of geographic diffusion of physicians from medically oversupplied toward undersupplied areas driven by economic competition among physicians and political interventions in Japan and US.Methods A quantitative evaluation of physician workforce changes at the community level between 1980 and 2005, using municipality-based (Japan) and county-based (US) census data.Results The overall number of physicians per 100,000 population (physician-to-population ratio: PPR) increased from 130 to 203 in Japan and 158 to 234 in US. In this context, a higher proportion (30.1%) of the quintile communities with lowest PPRs in 1980 has further decreased their PPRs in US than in Japan (21.6% in 2005). In multivariate analysis low PPR was a positive predictor of PPR decrease in the US communities (odds ratio 1.26; 95% confidence interval 1.01-1.58), while it was a negative predictor in Japanese communities (0.69; 0.57-0.83).Conclusions Physician scarcity is associated with further scarcity in US communities, while scarcity is associated with recovery from scarcity in Japanese communities. Competition-based physician diffusion strategies and various interventions to address the maldistribution of physicians apparently have not worked effectively in US compared with Japan.

Keywords: Physicians; Medically; underserved; areas; Health; policy; Japan (search for similar items in EconPapers)
Date: 2010
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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