scholarly journals Geographical distribution of family physicians in Japan: a nationwide cross-sectional study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Shuhei Yoshida ◽  
Masatoshi Matsumoto ◽  
Saori Kashima ◽  
Soichi Koike ◽  
Susumu Tazuma ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Rural Areas ◽  
Census Data ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Government Support ◽  
Free Access ◽  
Cross Sectional ◽  
Physician Distribution

Abstract Background Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution to this problem. Methods We obtained the workplace information of 527 (78.4%) of the 672 JPCA-certified family physicians from an online database. From the national census data, we also obtained the workplace information of board-certified general internists, surgeons, obstetricians/gynaecologists and paediatricians and of all physicians as the same-generation comparison group (ages 30 to 49). Chi-squared test and residual analysis were conducted to compare the distribution between family physicians and other specialists. Results Five hundred nineteen JPCA-certified family physicians and 137,587 same-generation physicians were analysed. The distribution of family physicians was skewed to municipalities with a lower population density, which shows a sharp contrast to the urban-biased distribution of other specialists. The proportion of family physicians in non-metropolitan municipalities was significantly higher than that expected based on the distribution of all same-generation physicians (p < 0.001). Conclusions Family physicians distributed in favour of rural areas much more than any other specialists in Japan. The better balance of family physician distribution reported from countries with a strong primary care orientation seems to hold even in a country where primary care orientation is weak, physician distribution is not regulated, and patients have free access to healthcare. Family physicians comprise only 0.2% of all Japanese physicians. However, if their population grows, they can potentially rectify the imbalance of physician distribution. Government support is mandatory to promote family medicine in Japan.

scholarly journals Geographical distribution of family physicians in Japan: A nationwide cross-sectional study

2019 ◽  
Author(s):  
Shuhei Yoshida ◽  
Masatoshi Matsumoto ◽  
Saori Kashima ◽  
Soichi Soichi Koike ◽  
Susumu Tazuma ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Rural Areas ◽  
Census Data ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Government Support ◽  
Free Access ◽  
Cross Sectional ◽  
Physician Distribution

Abstract Background Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution to this problem. Methods We obtained the workplace information of 527 (78.4%) of the 672 JPCA-certified family physicians from an online database. From the national census data, we also obtained the workplace information of board-certified general internists, surgeons, obstetricians/gynaecologists and paediatricians and of all physicians as the same-generation comparison group (ages 30 to 49). Chi-squared test and residual analysis were conducted to compare the distribution between family physicians and other specialists. Results 519 JPCA-certified family physicians and 137,587 same-generation physicians were analysed. The distribution of family physicians was skewed to municipalities with a lower population density, which shows a sharp contrast to the urban-biased distribution of other specialists. The proportion of family physicians in non-metropolitan municipalities was significantly higher than that expected based on the distribution of all same-generation physicians (p<0.001). Conclusions Family physicians distributed in favour of rural areas much more than any other specialists in Japan. The better balance of family physician distribution reported from countries with a strong primary care orientation seems to hold even in a country where primary care orientation is weak, physician distribution is not regulated, and patients have free access to healthcare. Family physicians comprise only 0.2% of all Japanese physicians. However, if their population grows, they can potentially rectify the imbalance of physician distribution. Government support is mandatory to promote family medicine in Japan.

scholarly journals Geographical distribution of family physicians in Japan: A nationwide cross-sectional study

2019 ◽  
Author(s):  
Shuhei Yoshida ◽  
Masatoshi Matsumoto ◽  
Saori Kashima ◽  
Soichi Koike ◽  
Susumu Tazuma ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Rural Areas ◽  
Census Data ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Government Support ◽  
Free Access ◽  
Cross Sectional ◽  
Physician Distribution

Abstract Background: Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution to this problem. Methods: We obtained the workplace information of 527 (78.4%) of the 672 JPCA-certified family physicians from an online database. From the national census data, we also obtained the workplace information of board-certified general internists, surgeons, obstetricians/gynaecologists and paediatricians and of all physicians as the same-generation comparison group (ages 30 to 49). Chi-squared test and residual analysis were conducted to compare the distribution between family physicians and other specialists. Results: 519 JPCA-certified family physicians and 137,587 same-generation physicians were analysed. The distribution of family physicians was skewed to municipalities with a lower population density, which shows a sharp contrast to the urban-biased distribution of other specialists. The proportion of family physicians in non-metropolitan municipalities was significantly higher than that expected based on the distribution of all same-generation physicians (p<0.001). Conclusions: Family physicians distributed in favour of rural areas much more than any other specialists in Japan. The better balance of family physician distribution reported from countries with a strong primary care orientation seems to hold even in a country where primary care orientation is weak, physician distribution is not regulated, and patients have free access to healthcare. Family physicians comprise only 0.2% of all Japanese physicians. However, if their population grows, they can potentially rectify the imbalance of physician distribution. Government support is mandatory to promote family medicine in Japan.

scholarly journals Geographical distribution of family physicians in Japan: A nationwide cross-sectional study

2019 ◽  
Author(s):  
Shuhei Yoshida ◽  
Masatoshi Matsumoto ◽  
Saori Kashima ◽  
Soichi Koike ◽  
Susumu Tazuma ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Rural Areas ◽  
Census Data ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Government Support ◽  
Free Access ◽  
Cross Sectional ◽  
Physician Distribution

Abstract Background: Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution to this problem. Methods: We obtained the workplace information of 527 (78.4%) of the 672 JPCA-certified family physicians from an online database. From the national census data, we also obtained the workplace information of board-certified general internists, surgeons, obstetricians/gynaecologists and paediatricians and of all physicians as the same-generation comparison group (ages 30 to 49). Chi-squared test and residual analysis were conducted to compare the distribution between family physicians and other specialists. Results: 519 JPCA-certified family physicians and 137,587 same-generation physicians were analysed. The distribution of family physicians was skewed to municipalities with a lower population density, which shows a sharp contrast to the urban-biased distribution of other specialists. The proportion of family physicians in non-metropolitan municipalities was significantly higher than that expected based on the distribution of all same-generation physicians (p<0.001). Conclusions: Family physicians distributed in favour of rural areas much more than any other specialists in Japan. The better balance of family physician distribution reported from countries with a strong primary care orientation seems to hold even in a country where primary care orientation is weak, physician distribution is not regulated, and patients have free access to healthcare. Family physicians comprise only 0.2% of all Japanese physicians. However, if their population grows, they can potentially rectify the imbalance of physician distribution. Government support is mandatory to promote family medicine in Japan.

Outshopping in rural periodic markets: a retailing opportunity

2014 ◽  
Vol 42 (2) ◽  
pp. 151-167 ◽  
Author(s):  
Sanal Kumar Velayudhan
Keyword(s):  
Rural Areas ◽  
Census Data ◽  
Cross Sectional Study ◽  
Superior Performance ◽  
Retail Stores ◽  
Retail Competition ◽  
Urban Context ◽  
Cross Sectional ◽  
Content Type ◽  
Retail Format

Purpose – The study seeks to understand the influences on the prevalence of rural retailing institution of periodic markets. It examines the influence of access to and population of the location on the performance of periodic markets and their effect on the competition between periodic markets and local rural retail stores. Design/methodology/approach – Simultaneous cross-sectional study on census data is used to understand changes in performance of periodic markets in the context of growth in retail stores. Findings – The superior performance of local retail shop compared to outshopping in periodic markets is contrary to observation in literature developed in the context of urban outshopping. Practical implications – Retail chains need to develop a separate program for location of outlets that serve rural areas as access influences retail performance. In rural areas marketers can use traditional periodic markets in addition to conventional retail store given the limited inter-format retail competition. Originality/value – This is one of the few studies to explicitly examine periodic markets as a retail format. Outshopping is studied in the context of growth in local retail stores unlike earlier studies in the urban context where the local stores exhibit reduced sales.

scholarly journals Family medicine residents' risk of adverse motor vehicle events: comparison between rural and urban placements.

2013 ◽  
Vol 4 (2) ◽  
pp. e28-e40 ◽  
Author(s):  
Fred Janke ◽  
Bonnie Dobbs ◽  
Rhianne McKay ◽  
Meghan Lindsell ◽  
Oksana Babenko
Keyword(s):  
Family Medicine ◽  
Rural Areas ◽  
Urban Areas ◽  
Motor Vehicle ◽  
Medical Schools ◽  
Cross Sectional Study ◽  
Urban Residents ◽  
Rural Residents ◽  
Cross Sectional ◽  
Family Medicine Residents

Background: Sleep deprivation and fatigue are associated with long and irregular work hours. These work patterns are common to medical residents. Motor vehicle crashes (MVCs) are a leading cause of injury related deaths in Canada, with MVC fatality rates in rural areas up to three times higher than in urban areas. Objectives: To: 1) examine the number of adverse motor vehicle events (AMVEs) in family medicine residents in Canada; 2) assess whether residents with rural placements are at greater risk of experiencing AMVEs than urban residents; and 3) determine if family medicine residency programs across Canada have travel policies in place. Methodology: A prospective, cross-sectional study, using a national survey of second-year family medicine residents. Results: A higher percentage of rural residents reported AMVEs than urban residents. The trend was for rural residents to be involved in more MVCs during residency, while urban residents were more likely to be involved in close calls. The majority of Canadian medical schools do not have resident travel policies in place. Conclusion: AMVEs are common in family medicine residents, with a trend for the number of MVCs to be greater for rural residents. These data support the need for development and incorporation of travel policies by medical schools.

scholarly journals Primary Care Professionals’ Acceptance of Medical Record-Based, Store and Forward Provider-to-Provider Telemedicine in Catalonia: Results of a Web-Based Survey

2020 ◽  
Vol 17 (11) ◽  
pp. 4092
Author(s):  
Josep Vidal-Alaball ◽  
Francesc López Seguí ◽  
Josep Lluís Garcia Domingo ◽  
Gemma Flores Mateo ◽  
Gloria Sauch Valmaña ◽  
...  
Keyword(s):  
Primary Care ◽  
Technology Acceptance ◽  
Medical Record ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Key Factor ◽  
Store And Forward ◽  
Primary Care Professionals

While telemedicine services enjoy a high acceptance among the public, evidence regarding clinician’s acceptance, a key factor for sustainable telemedicine services, is mixed. However, telemedicine is generally better accepted by both patients and professionals who live in rural areas, as it can save them significant time. The objective of this study is to assess the acceptance of medical record-based, store and forward provider-to-provider telemedicine among primary care professionals and to describe the factors which may determine their future use. This is an observational cross-sectional study using the Catalan version of the Health Optimum questionnaire; a technology acceptance model-based validated survey comprised of eight short questions. The online, voluntary response poll was sent to all 661 primary care professionals in 17 primary care teams that had potentially used the telemedicine services of the main primary care provider in Catalonia, in the Central Catalan Region. The majority of respondents rated the quality of telemedicine consultations as “Excellent” or “Good” (83%). However, nearly 60% stated that they sometimes had technical, organizational or other difficulties, which might affect the quality of care delivered. These negatively predicted their declared future use (p = 0.001). The quality of telemedicine services is perceived as good overall for all the parameters studied, especially among nurses. It is important that policymakers examine and provide solutions for the technical and organizational difficulties detected (e.g., by providing training), in order to ensure the use of these services in the future.

scholarly journals Diagnostic and laboratory test ordering in Northern Portuguese Primary Health Care: a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018509 ◽  
Author(s):  
Luísa Sá ◽  
Andreia Sofia Costa Teixeira ◽  
Fernando Tavares ◽  
Cristina Costa-Santos ◽  
Luciana Couto ◽  
...  
Keyword(s):  
Primary Care ◽  
Laboratory Tests ◽  
Family Health ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Health Administration ◽  
Regional Health ◽  
Cross Sectional ◽  
Primary Health ◽  
Test Ordering

ObjectivesTo characterise the test ordering pattern in Northern Portugal and to investigate the influence of context-related factors, analysing the test ordered at the level of geographical groups of family physicians and at the level of different healthcare organisations.DesignCross-sectional study.SettingNorthern Primary Health Care, Portugal.ParticipantsRecords about diagnostic and laboratory tests ordered from 2035 family physicians working at the Northern Regional Health Administration, who served approximately 3.5 million Portuguese patients, in 2014.OutcomesTo determine the 20 most ordered diagnostic and laboratory tests in the Northern Regional Health Administration; to identify the presence and extent of variations in the 20 most ordered diagnostic and laboratory tests between the Groups of Primary Care Centres and between health units; and to study factors that may explain these variations.ResultsThe 20 most ordered diagnostic and laboratory tests almost entirely comprise laboratory tests and account for 70.9% of the total tests requested. We can trace a major pattern of test ordering for haemogram, glucose, lipid profile, creatinine and urinalysis. There was a significant difference (P<0.001) in test orders for all tests between Groups of Primary Care Centres and for all tests, except glycated haemoglobin (P=0.06), between health units. Generally, the Personalised Healthcare Units ordered more than Family Health Units.ConclusionsThe results from this study show that the most commonly ordered tests in Portugal are laboratory tests, that there is a tendency for overtesting and that there is a large variability in diagnostic and laboratory test ordering in different geographical and organisational Portuguese primary care practices, suggesting that there may be considerable potential for the rationalisation of test ordering. The existence of Family Health Units seems to be a strong determinant in decreasing test ordering by Portuguese family physicians. Approaches to ensuring more rational testing are needed.

scholarly journals Free access to medicines among older adults in primary care: a cross-sectional study

2020 ◽  
Vol 138 (3) ◽  
pp. 235-243
Author(s):  
Isabela Vaz Leite Pinto ◽  
Marina Guimarães Lima ◽  
Laís Lessa Neiva Pantuzza ◽  
Maria das Graças Braga Ceccato ◽  
Micheline Rosa Silveira ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Access To Medicines ◽  
Cross Sectional Study ◽  
Free Access ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Socio-demographic associations of HIV among antenatal care attendees in selected rural primary care facilities in South Africa's Eastern Cape province

2020 ◽  
Author(s):  
Sikhumbuzo A Mabunda ◽  
Khuthala Sigovana ◽  
Wezile Chitha ◽  
Teke Apalata ◽  
Sibusiso Nomatshila
Keyword(s):  
Primary Care ◽  
Antenatal Care ◽  
Rural Areas ◽  
Statistical Significance ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Hiv Prevalence ◽  
P Value ◽  
Cross Sectional ◽  
Care Facilities

Abstract Background To effectively reduce vertical HIV transmission requires a reduction of HIV prevalence and incidence among pregnant women and a full understanding of its epidemiology. There is, however, literature paucity of HIV studies focusing on women attending antenatal care in rural areas in South Africa. Methods A Cross-sectional study of women attending antenatal care in four Primary Care facilities was conducted using an interviewer-administered questionnaire which collected information on socio-demographic characteristics and medical history. Binomial logistic regression analyses were used to determine factors associated with HIV and to estimate the prevalence ratio (PR). The 95% confidence interval (95%CI) is used for precision of estimates; p ≤ 0.05 for statistical significance. Results A total of 343 participants were recruited. The antenatal HIV prevalence was 38.2% (95%CI: 33.2–43.9). Participants older than 40 years were 4.6 times significantly more likely to be HIV positive compared to teenagers (p-value = 0.019). Furthermore, multiparous, unemployed and employed participants, were significantly associated with 40%, 60% and 70% higher antenatal HIV prevalences respectively when compared to primigravidas or tertiary students (p-value < 0.0001). Conclusion Despite a 100% antenatal HIV testing rate, the antenatal HIV prevalence remains high and is increasing in this population, coupled with no spousal attendance in antenatal care and poor condom compliance. It is therefore important to remain vigilant and monitor mother-to-child transmission that could be associated with this increased prevalence.

scholarly journals Exercise Counseling by Primary Care Physicians in Jordan—A Preliminary Study

2020 ◽  
Vol 11 ◽  
pp. 215013272094694
Author(s):  
Othman Beni Yonis ◽  
Rami Saadeh ◽  
Zaher Chamseddin ◽  
Hussam Alananzeh
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Public And Private ◽  
Logistic Regression Models ◽  
Exercise Counseling ◽  
Chi Square Test

Despite the value of physical activity and exercise to patients, little is known about the perception and practices of Jordanian primary care physicians (PCPs) regarding counseling patients about exercise. This study was aimed at assessing counseling about exercise by PCPs in Jordan. A cross-sectional study targeting a random sample of physicians from family medicine, internal medicine and general practice in academic, public, and private sectors. Chi-square test of independence was used to assess the association of perceptions and practices of physicians regarding exercise counseling with their specialty. Logistic regression models were used to examine the association of demographic information with selected items of perception and practice. A total of 218 physicians participated in the study. They were mainly males (67%), family medicine physicians (42.2%), and had a mean age of 33.7 (±9.87) years. Most physicians believed that less than half of patients will start exercising (91.3%) or will continue exercising if they were repeatedly counseled at follow-up visits (85.4%). Family medicine physicians counseled more patients, more frequently, and their desire to counsel more patients was significantly higher than other physicians ( P = .002). The Perceptions and practices of Jordanian PCPs toward exercise counseling for their patients were found positive; however the desire to counsel more patients was low. Lack of patients’ motivation to practice exercise, time constraint and limited resources were the most frequently reported barriers to counseling. Further investigation on how to overcome such barriers is recommended.

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