日本医生的供需和分布情况

Hiroyasu Nishiyama, Yoshihiro Mizuma, Nobuo Handa, Ryong-moon Shin
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摘要

日本的医生数量一直并将继续低于经济合作与发展组织(OECD)的其他国家。对医生数量影响最大的医学院校的招生能力,是由厚生劳动省、医学会、医疗组织、大学和学术界根据当时的医疗供需状况讨论决定的。近年来,医学专业和地区分布不均已成为一个问题。为解决这一问题,日本政府从多个角度入手,包括在大学医学院的招生名额中设置 "地区配额",在专科医生制度中设置各都道府县的住院医师职位数量和招聘能力上限等。对医生实施的 "工作方式改革 "侧重于缩短医生的工作时间,引起了对医生短缺和地区分布不均的担忧。政府的政策基于一个主要关切:医疗费用的上涨可能会严重威胁国家的财政健康。因此,政府限制了医生数量的增加。与此相反,今年政府开始认为有必要采取监管措施来解决医生分布不均的问题。我们的主张是实现与其他经合组织国家相当的医生数量,并创造一种环境,使医生能够自愿解决其地区和部门分布不均的问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Supply, Demand and Distribution of Physicians in Japan
The number of physicians in Japan has been and will continue to be lower than that in other the Organization for Economic Co-operative and Development (OECD) countries. The admission capacity of medical schools, which has the greatest impact on the number of physicians, has been determined through discussions among the Ministry of Health, Labour and Welfare, medical associations, medical organizations, universities, and academics, depending on the medical supply-demand status on that era. In recent years, the maldistribution of medical specialties and regions has become an issue. For the involving this issue, Japanese government takes from multiple perspectives to address this problem, including “regional quotas” in admission quotas for university medical school and, setting a ceiling on the number of residency positions available in each prefecture as well as on recruitment capacity in the specialist physician system. The implementation of “work style reform” for physicians, focuses on shortening physicians’ working hours and has raised concerns regarding a shortage and regional maldistribution of physicians. The government’s policy is based on a key concern: rising healthcare costs could seriously threaten the country’s financial health. Therefore, the government has limited the increase in the number of physicians. Conversely, this year, the government has begun to argue that a regulatory approach is necessary to address the uneven distribution of physicians. Our proposition is to achieve a number of physicians comparable to that of other OECD countries and to create an environment that enables physicians to voluntarily address their regional and departmental maldistribution.
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