Abstract
Background: We have suspected that the regional differences in the emergency medical field are due to the lack of the numbers of emergency medical doctors and emergency medical institutions in Japan. Therefore, in this study we investigated the regional distribution of the numbers of emergency medical doctors and institutions. Methods: We compared the numbers of regular members, diplomats of the Board of Japanese Association for Acute Medicine (JAAM), certified training hospitals of JAAM against population size, the numbers of medical doctors, general hospitals, hospital beds in the 47 prefectures and the nine areas recognized by the eight district societies of JAAM. Results: There were significant correlations in all comparisons between population size, the numbers of medical doctors, general hospitals, hospital beds, regular members, diplomats of the Board, and certified training hospitals of JAAM in the 47 prefectures. The average number of regular members of JAAM per 100, 000 population was 6.2. The maximum difference among 47 prefectures (MDP) was 5.4 times. It was largest (9.2) in the Tokyo area and smallest (4.8) in the Kanto area. The average number of diplomats of the Board of JAAM per 100, 000 population was 1.8. MDP was 7.5 times. It was largest (3.1) in the Tokyo area and smallest (1.1) in the Hokuriku area. The Tokyo and Kinki areas had significantly larger numbers. The percentage of regular members of JAAM per medical doctor was 3.0%. MDP was 5.1 times. It was highest (3.6%) in the Hokkaido area and lowest (2.4%) in the Hokuriku area. The percentage of diplomats of the Board of JAAM per medical doctor was 0.9%. MDP was 7.6 times. It was highest (1.2%) in the Tokyo area and lowest (0.6%) in the Hokuriku area. The average number of regular members of JAAM per one general hospital was 0.9. The MDP was 5.8 times. It was largest (1.7) in the Tokyo area and smallest (0.6) in the Chugoku-Shikoku area. The Tokyo and Kinki areas had significantly larger numbers. The average number of diplomats of the Board of JAAM per one general hospital was 0.3. MDP was 10.2 times. It was largest (0.6) in the Tokyo area and smallest (0.1) in the Hokuriku area. The Tokyo and Kinki areas had significantly larger numbers. The average number of regular members of JAAM per 1, 000 hospital beds was 4.8. The MDP was 5.0 times. It was largest (8.7) in the Tokyo area and smallest (3.7) in the Chugoku-Shikoku area. The Tokyo and Kinki areas had significantly larger numbers. The average number of diplomats of the Board of JAAM per 1, 000 hospital beds was 1.4. MDP was 8.2 times. It was largest (2.9) in the Tokyo area and smallest (0.8) in the Hokuriku area. The Tokyo and Kinki areas had the significantly larger numbers. The percentage of certified training hospitals of JAAM per general hospital was 2.9%. MDP was 10.2 times. It was highest (4.8%) in the Tokyo area and lowest (2.1%) in the Kyushu area. Conclusion: These results suggest that there are the regional discrepancies in the numbers of emergency medical doctors in Japan. The Tokyo and Kinki areas have the largest numbers of emergencies medical doctors. We should correct the regional differences in the numbers of emergency medical doctors and emergency medical institutions among the areas in Japan.
