Education policies to increase rural physicians in Japan: a nationwide cohort study

Matsumoto, Masatoshi; Matsuyama, Yasushi; Kashima, Saori; Koike, Soichi; Okazaki, Yuji; Kotani, Kazuhiko; Owaki, Tetsuhiro; Ishikawa, Shizukiyo; Iguchi, Seitaro; Okazaki, Hitoaki; Maeda, Takahiro

doi:10.1186/s12960-021-00644-6

Human Resources for Health

Table 2 Distribution of subjects between metropolitan and nonmetropolitan municipalities

From: Education policies to increase rural physicians in Japan: a nationwide cohort study

Category	Metro^a	Non metro^b	Total	% of nonmetro	P value	RR^c of nonmetro	95% CI
PGY-1
All graduates	5077	3634	8711	41.7	Reference	1.000	NA–NA
Scholarship alone	36	76	112	67.9	< 0.001	1.627	1.429–1.852
Quota alone	68	40	108	37.0	> 0.99	0.888	0.693–1.137
Quota with scholarship	108	137	245	55.9	< 0.001	1.340	1.196–1.502
Jichi	69	58	127	45.7	> 0.99	1.095	0.904–1.326
PGY-2
All graduates	4938	3271	8209	39.8	reference	1.000	NA–NA
Scholarship alone	63	67	130	51.5	0.036	1.293	1.093–1.531
Quota alone	75	53	128	41.4	> 0.99	1.039	0.844–1.279
Quota with scholarship	94	91	185	49.2	0.051	1.234	1.064–1.433
Jichi	55	46	101	45.5	> 0.99	1.143	0.922–1.417
PGY-3
All graduates	5233	2962	8195	36.1	Reference	1.000	NA–NA
Scholarship alone	53	61	114	53.5	< 0.001	1.480	1.245–1.761
Quota alone	56	39	95	41.1	> 0.99	1.136	0.891–1.448
Quota with scholarship	75	106	181	58.6	< 0.001	1.620	1.429–1.838
Jichi	19	95	114	83.3%	< 0.001	2.306	2.114–2.515
PGY-4
All graduates	4559	3247	7806	41.6	Reference	1.000	NA–NA
Scholarship alone	48	84	132	63.6%	< 0.001	1.530	1.341–1.745
Quota alone	57	46	103	44.7%	> 0.99	1.074	0.865–1.333
Quota with scholarship	44	92	136	67.6%	< 0.001	1.626	1.444–1.832
Jichi	4	107	111	96.4%	< 0.001	2.317	2.216–2.423
PGY-5
All graduates	4171	3201	7372	43.4%	Reference	1.000	NA–NA
Scholarship alone	41	66	107	61.7%	< 0.001	1.421	1.221–1.653
Quota alone	27	22	49	44.9%	> 0.99	1.034	0.757–1.412
Quota with scholarship	28	42	70	60.0%	0.031	1.382	1.139–1.676
Jichi	12	94	106	88.7%	< 0.001	2.042	1.899–2.197
Total
All graduates	23,978	16,315	40,293	40.5%	Reference	1.000	NA–NA
Scholarship alone	241	354	595	59.5%	< 0.001	1.469	1.374–1.572
Quota alone	283	200	483	41.4%	> 0.99	1.023	0.919–1.138
Quota with scholarship	349	468	817	57.3%	< 0.001	1.415	1.332–1.503
Jichi	159	400	559	71.6%	< 0.001	1.767	1.675–1.865

PGY postgraduate year; RR relative risk; CI confidence interval; Jichi Jichi Medical University
^aMetropolis: wards of the ordinance-designated cities, special wards of Tokyo, and center cities
^bNonmetropolis: other cities and towns/villages
^cRelative risk of nonmetropolis against metropolis with "all graduates" being the reference group
P value was calculated with Chi-square test with Bonferroni adjustment

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ISSN: 1478-4491

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