Projections of psychiatrists' distribution for patients in Japan: a utilization-based approach

Abstract

Background: Depopulation accompanied by population aging is a major public health concern in Japan. Although adequate allocation of mental healthcare resources is needed, there have been few studies on the impact of population change on the supply-demand balance for mental illness in Japan. The aim of this study is to predict psychiatrists' distribution for patients with mental illness via a utilization-based approach.

Methods: We set patients with schizophrenia, mood disorders, vascular dementia or Alzheimer's disease as study subjects and conducted analyses for 2015, 2025, 2035, and 2045 across all prefectures. Moreover, we evaluated the regional maldistribution of demand and supply by calculating the number of psychiatrists per patient, Gini coefficients (GC), and Herfindahl-Hirschman Index (HHI).

Results: The mean number of psychiatrists per patient for patients with schizophrenia, mood disorders, vascular dementia, and Alzheimer's disease in 2025, 2035, and 2045 was significantly lower than in 2015. For all of the abovementioned diseases, both the GC and HHI will increase until 2045.

Conclusion: If psychiatrists are allocated at the current population-to-psychiatrist ratio, the shortage of psychiatrists will continue to worsen in the future. To overcome this inequity, policy makers should make plans to shift responsibilities from psychiatrists to other mental health workers and to ensure the adequate geographical allocation of healthcare resources.

Keywords: Demand–supply balance; Forecasting; Maldistribution; Utilization-based approach.

Fig. 1

The relationship between population and patient growth rate from 2015 to 2045 in each prefecture

Fig. 2

Forecasted Gini coefficients. GC Gini coefficient

Fig. 3

Forecasted Herfindahl–Hirschman Index. HHI Herfindahl–Hirschman Index