Shortage of pediatricians in Japan: a longitudinal analysis using physicians' survey data.
BACKGROUND
Currently, there is a shortage of hospital pediatricians in Japan. In the present study, using data from the Survey of Physicians, Dentists, and Pharmacists in Japan, we analyzed the dynamics and distribution of pediatricians, using a time series approach.


METHODS
The total number of pediatricians, the ratios of hospital-working and female pediatricians, their mean age and geographic distribution in 1974, 1984, 1994, and 2004 were determined. The dynamics of pediatricians were analyzed by identifying the annual number of physicians participating in and withdrawing from pediatrics, and by following up withdrawal rates from pediatrics and movement rates from hospitals. The withdrawal rates of male and female pediatricians registered in 1992, 1994, and 1996 were also analyzed.


RESULTS
The number of pediatricians per 10,000 children increased from 1.9 to 7.4 between 1974 and 2004. The percentage of women among pediatricians was significantly higher than that of women among all physicians in 2004 (P < 0.01). The numbers of physicians who withdrew from pediatrics increased from the periods 1985-1994 to 1995-2004. Younger pediatricians tended to leave pediatrics earlier than elder pediatricians. There were no differences in the withdrawal rates of pediatricians between men and women registered in 1992, 1994, and 1996.


CONCLUSIONS
It is anticipated that the number of pediatricians in Japan will decrease in the near future unless practical strategies are implemented to improve the early withdrawal of younger pediatricians and the current working conditions of female pediatricians.
Ide
Hiroo
H
Department of Planning, Information, and Management, The University of Tokyo Hospital, Tokyo, Japan. idea-tky@umin.ac.jp
Yasunaga
Hideo
H
Koike
Soichi
S
Kodama
Tomoko
T
Igarashi
Takashi
T
Imamura
Tomoaki
T
D000328:Adult; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010372:Pediatrics; D010820:Physicians / Q000600:supply & distribution*; D000078329:Workforce