Geographical imbalances in the health workforce, particularly the shortage of health care workers in rural areas, is an issue of social and political concern in most countries. Estimating the number of required doctors is essential for evidence-based health policy planning. In this study, we propose two methods for estimating the number of required doctors using a simple method. One is counting by unit and the other is incorporating access to medical institutions. The purpose of this study is to verify the need to incorporate access to medical institutions when estimating the number of required physicians in a region by comparing both estimation methods from the viewpoint of regional population density. We calculated the ratio of outpatients who can access medical institutions and the number of required physicians using the travel time by car and the number of patients who can be treated per doctor per day (estimation method for the number of physicians based on the access simulation, hereinafter referred to as EAS). We compared the results of this estimation with those of a conventional method, such as the number of doctors per population (estimation method for the number of physicians based on the number of patients, hereinafter referred to as ENP) to show how important it is to incorporate the element of accessibility in such a simulation analysis. Based on the results, we discussed the applicability of the proposed method. ENP estimated that 38,685 outpatient primary care (PC) physicians were required and EAS estimated that 46,378 were required. There was a difference of about 8000. A comparison of the EAS-estimated number of physicians and the ENP-estimated number of physicians showed that the ENP-estimated number was small, particularly in areas with low population density. The results showed that it is effective to use the proposed EAS method for the estimation of PC physicians, particularly in areas with low population density. We showed that the method of allocating the number of physicians in proportion to the number of patients in a certain unit requires paying attention to the setting of the unit.

中文翻译：

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将可及性纳入估算所需医生数量的效果和意义：关注目标地区人口密度的差异


卫生人力的地域不平衡，特别是农村地区卫生保健人员的短缺，是大多数国家社会和政治关注的问题。估计所需医生的数量对于循证卫生政策规划至关重要。在本研究中，我们提出了两种使用简单方法来估计所需医生数量的方法。一是按单位统计，二是纳入医疗机构准入。本研究的目的是通过从区域人口密度的角度比较两种估算方法，验证在估算一个地区所需医生数量时是否需要考虑医疗机构的可及性。我们利用乘车时间和每位医生每天可以治疗的患者数量，计算出可以访问医疗机构的门诊患者比例和所需医生人数（基于访问模拟的医生人数估算方法，以下简称EAS）。我们将这种估计的结果与传统方法的结果进行比较，例如每人口的医生数量（基于患者数量的医生数量估计方法，以下简称ENP），以表明将可访问性元素纳入此类模拟分析中。根据结果​​，我们讨论了所提出方法的适用性。 ENP 估计需要 38,685 名门诊初级保健 (PC) 医生，EAS 估计需要 46,378 名。相差8000左右。 EAS 估计的医生人数与 ENP 估计的医生人数的比较表明，ENP 估计的医生人数较少，特别是在人口密度较低的地区。结果表明，使用所提出的 EAS 方法来估计 PC 医生是有效的，特别是在人口密度较低的地区。我们表明，在某个单位按照患者人数比例分配医生人数的方法需要注意单位的设置。