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The distance and chance of lifetime geographical movement of physicians in Japan: an analysis using the age-period-cohort model

Overview of attention for article published in Human Resources for Health, June 2018
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (76th percentile)

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Title
The distance and chance of lifetime geographical movement of physicians in Japan: an analysis using the age-period-cohort model
Published in
Human Resources for Health, June 2018
DOI 10.1186/s12960-018-0289-5
Pubmed ID
Authors

Hiroo Ide, Shunsuke Doi, Hidenao Atarashi, Shinsuke Fujita, Soichi Koike

Abstract

The uneven geographical distribution of physicians in Japan is a result of those physicians electing to work in certain locations. In order to understand this phenomenon, it is necessary to analyze the geographic movement of physicians across the Japanese landscape. We obtained individual data on physicians from 1978 to 2012 detailing their attributes, work institutions, and locations. The data are from Japanese governmental sources (the Survey of Physicians, Dentists, and Pharmacists). The total sample size was 122 150 physicians, with 77.5% being male and 22.5% female. After obtaining the data, we calculated the geographical distance of each physician's movement by using geographic information systems software (GIS; ArcGIS, ESRI, Inc., CA, USA). Geographical distance was then converted into time distance. We compared the resulting median values through nonparametric testing and then conducted a multivariate analysis. Our next step involved the use of an age-period-cohort (APC) model to measure the degree of impact three points of data, experience (experience years), the historical and environmental context of the data (survey year), and physician cohort (registration year) had on the movement of each physician. The ratio of female physicians who selected an urban area as their first working location was higher than that of male physicians. However, the selection of an urban area was becoming more popular as a first working location for both males and females as the year of data increased. The overall distance of geographical movement for female physicians was less than it was for male physicians. Physicians moved the greatest distance between their second and fourth years following license acquisition, at which point the time distance became shorter. The median time distance was 46 min in 2000 and 22 min in 2008. The physicians in our study did not move far from their first working location, and the overall distance of movement lessened in the more recent years of study. The median distance of movement after 20 years was 25.9 km for male physicians, and 19.1 km for female physicians. The results of the APC model indicated that the effects of experience years (age) gradually declined, that the survey year (period) effects increased, and that the registration year (cohort) effects increased initially before leveling off. The trends following the introduction of the new mandatory training system in 2004 may imply that the concentration of physicians in Japan's urban areas is expected to increase. After 2000, the effect of that period on physicians explains their geographical movements more so than the factor of their age.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 27 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 3 11%
Lecturer 3 11%
Student > Ph. D. Student 3 11%
Student > Doctoral Student 2 7%
Student > Bachelor 2 7%
Other 7 26%
Unknown 7 26%
Readers by discipline Count As %
Medicine and Dentistry 8 30%
Social Sciences 3 11%
Business, Management and Accounting 2 7%
Linguistics 1 4%
Nursing and Health Professions 1 4%
Other 4 15%
Unknown 8 30%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 June 2018.
All research outputs
#4,314,251
of 25,382,440 outputs
Outputs from Human Resources for Health
#508
of 1,261 outputs
Outputs of similar age
#77,930
of 341,533 outputs
Outputs of similar age from Human Resources for Health
#10
of 13 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. Compared to these this one has done well and is in the 82nd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,261 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.3. This one has gotten more attention than average, scoring higher than 58% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 341,533 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 76% of its contemporaries.
We're also able to compare this research output to 13 others from the same source and published within six weeks on either side of this one. This one is in the 15th percentile – i.e., 15% of its contemporaries scored the same or lower than it.