This study intends to reveal actual conditions surrounding the nation's perinatal medical care system, mainly from the perspectives of disparities among secondary medical care areas and assessment of medical resource intensity, by using the results of a fact-finding survey on facilities providing delivery care conducted by the Japan Society of Obstetrics and Gynecology and the Japan Association of Obstetricians and Gynecologists in 2014. As a result, it was again confirmed that there are large disparities among secondary medical care areas in terms of facilities providing delivery care, placement of doctors, a division of roles between hospitals and clinics, and scale of medical institutions. While the society and others have set a goal of increasing the number of local base hospitals dealing with delivery care, each of which is staffed with more than 10 full-time obstetrics and gynecology specialists, the number is limited as there are 145 such hospitals across the nation. The number of births in secondary medical care areas which have such hospitals was 573,865 in total, accounting for 56 percent of the total number of births across the nation, suggesting the necessity to consolidate medical institutions and expand their scales. When the Herfindahl Hirschman Index, or HHI, is used as an evaluation method for the intensity, the HHI was considered to be useful in comparing medical care areas where the number of deliveries are nearly equal and conducting time-series assessment. In addition, concerning the numbers of deliveries and full-time doctors per medical institution, the HHI was considered to be helpful as an index.
