Forecasting the absolute and relative shortage of physicians in Japan using a system dynamics model approach
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RESEARCH
Open Access
Forecasting the absolute and relative shortage of physicians in Japan using a system dynamics model approach Tomoki Ishikawa1, Hisateru Ohba2, Yuki Yokooka3, Kozo Nakamura1 and Katsuhiko Ogasawara4*
Abstract Background: In Japan, a shortage of physicians, who serve a key role in healthcare provision, has been pointed out as a major medical issue. The healthcare workforce policy planner should consider future dynamic changes in physician numbers. The purpose of this study was to propose a physician supply forecasting methodology by applying system dynamics modeling to estimate future absolute and relative numbers of physicians. Method: We constructed a forecasting model using a system dynamics approach. Forecasting the number of physician was performed for all clinical physician and OB/GYN specialists. Moreover, we conducted evaluation of sufficiency for the number of physicians and sensitivity analysis. Result & conclusion: As a result, it was forecast that the number of physicians would increase during 2008–2030 and the shortage would resolve at 2026 for all clinical physicians. However, the shortage would not resolve for the period covered. This suggests a need for measures for reconsidering the allocation system of new entry physicians to resolve maldistribution between medical departments, in addition, for increasing the overall number of clinical physicians. Keywords: Forecasting the number of physicians, Shortage of physician, Maldistribution, System dynamics
Introduction Health policy planning for human resources has become an internationally high priority [1]. In Japan, a shortage of physicians, who serve a key role in healthcare provision, has been pointed out as a major medical issue [2]. The Ministry of Health, Labour and Welfare (MHLW) reported that there is lack of absolute and relative numbers of physicians, as well as maldistribution among regions and medical departments. To ease the personnel shortage in Japan, the MHLW estimated that hospitals need a further 24 000 physicians [3]. It has been suggested that the policy of decreasing medical school enrolment quotas is a major factor behind the absolute shortage of physicians [4,5]. In 1982 and 1999, the policy was approved by the Japanese Government to prevent future oversupply. The medical school enrolment quota had decreased from 8 280 * Correspondence: [email protected] 4 Faculty of Health Sciences, Hokkaido University, N12W5, Kita-ku, Sapporo 060-0812, Japan Full list of author information is available at the end of the article
students in 1984 to 7 625 in 2007. However, the number of physicians per unit of population in Japan is low compared with other developed countries [6]. According to Organization for Economic Co-operation and Development (OECD) data, the number of medical doctors per 1 000 persons in Japan was 2.2 in 2008; this number was 2.4 in the US in 2009 and 2.7 in the UK in 2010. The number of physicians in Japan has always been lower than the OECD average. In 2008 the MHLW identified the physician suppl
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