Community characteristics that attract physicians in Japan: a cross-sectional analysis of community demographic and economic factors

<p>Abstract</p> <p>Background</p> <p>In many countries, there is a surplus of physicians in some communities and a shortage in others. Population size is known to be correlated with the number of physicians in a community, and is conventionally considered to represent the power of communities to attract physicians. However, associations between other demographic/economic variables and the number of physicians in a community have not been fully evaluated. This study seeks other parameters that correlate with the physician population and show which characteristics of a community determine its "attractiveness" to physicians.</p> <p>Methods</p> <p>Associations between the number of physicians and selected demographic/economic/life-related variables of all of Japan's 3132 municipalities were examined. In order to exclude the confounding effect of community size, correlations between the physician-to-population ratio and other variable-to-population ratios or variable-to-area ratios were evaluated with simple correlation and multiple regression analyses. The equity of physician distribution against each variable was evaluated by the orenz curve and Gini index.</p> <p>Results</p> <p>Among the 21 variables selected, the service industry workers-to-population ratio (0.543), commercial land price (0.527), sales of goods per person (0.472), and daytime population density (0.451) were better correlated with the physician-to-population ratio than was population density (0.409). Multiple regression analysis showed that the service industry worker-to-population ratio, the daytime population density, and the elderly rate were each independently correlated with the physician-to-population ratio (standardized regression coefficient 0.393, 0.355, 0.089 respectively; each p < 0.001). Equity of physician distribution was higher against service industry population (Gini index = 0.26) and daytime population (0.28) than against population (0.33).</p> <p>Conclusion</p> <p>Daytime population and service industry population in a municipality are better parameters of community attractiveness to physicians than population. Because attractiveness is supposed to consist of medical demand and the amenities of urban life, the two parameters may represent the amount of medical demand and/or the extent of urban amenities of the community more precisely than population does. The conventional demand-supply analysis based solely on population as the demand parameter may overestimate the inequity of the physician distribution among communities.</p

Rethinking activism: tourism, mobilities and emotion

This article seeks to trouble distinctions between activism and tourism, and activism and regionality. It does this by exploring the role of tourism, mobilities and emotion for a regional Australian queer collective, and their 1400 km return journey to the Sydney Gay and Lesbian Mardi Gras Parade. In illustrating the ways this touristic journey represents alternative ways of performing queer activism, I argue that the existence of regional activism deconstructs notions that non-normative sexualities and queer politics do not exist beyond urban centres. Granting attention to the alternative ways the queer collective utilises tourism mobilities as part of their activism strengthens characterisations of leisure as always more than a space of hedonism and escape. Understanding the broader significance of events enables scholars to rethink festivals as spatially and temporally bounded, one off events but rather crucial to the ongoing sustainability of regional queer collectives and performances of queer activism in peripheral areas

Hospital admissions in the National Health Survey and hospital separations in the National Hospital Morbidity Dataset: what is the difference?

Objective: To compare the National Health Survey (NHS) derived estimates of hospital admissions with the number of hospital separations registered in the National Hospital Morbidity Dataset (NHMD). Methods: Using the person weights in the NHS, the Expanded Confidential Unit Record File of the 2004-05 NHS was used to derive a population estimate of the number of hospital admissions in the 12 months preceding the conduct of the survey. These estimates, by age and sex categories and whether or not the admission involved an overnight stay, were compared with the number of hospital separations registered in the NHMD. Results: The number of hospital admissions estimated from the NHS was approximately two thirds the number of hospital separations registered in the NHMD. The discrepancy between the two data sources was greater when hospital episodes did not involve an overnight stay in hospital. Conclusion: There are systematic differences between the number of admissions/separations derived by the NHS and the NHMD for reasons including the technical difference between a hospital admission and a separation, and the sampling frame and scope of the NHS. Researchers looking for individual level data on hospital utilisation must take note of the differences between NHS and the NHMD, and recognise that there are methods to simulate a representative population by enhancing an existing dataset with information from multiple data sources, thus providing researchers a cost-effective data resource. © 2008 The Authors. Journal Compilatio