Correlation between the number of laparoscopy‐qualified gynecologists and the proportion of laparoscopic surgeries for benign gynecological diseases in Japan: An ecological study

Abstract

AimWe aimed to evaluate regional disparities in the proportion of the three main laparoscopic surgeries for benign gynecological diseases among 47 prefectures in Japan and their correlation with the number of laparoscopy‐qualified gynecologists per population.MethodsIn this retrospective ecological study, we collected the data of patients from 47 prefectures in 2017 using “The National Database of Health Insurance Claims and Specific Health Checkups of Japan” Open Data from the Ministry of Health, Labor and Welfare in Japan. The primary outcome of the study was the proportion of laparoscopic surgeries conducted for benign gynecologic diseases (hysterectomy, myomectomy and surgery for the benign ovarian diseases). The main exposure was the number of laparoscopy‐qualified gynecologists per 100 000 females.ResultsThe average proportion of laparoscopic hysterectomies, myomectomies and surgeries for the benign ovarian disease were 38% (standard deviation (SD) 16, range 12–74), 48% (SD 18, range 9–81) and 60% (SD 11, range 36–79), respectively. Multiple regression analysis showed a significant correlation between the number of laparoscopy‐qualified gynecologists per 100 000 females and the proportion of the three main laparoscopic surgeries.ConclusionThere are obvious regional disparities in the proportion of the three main laparoscopic procedures for benign gynecological diseases among 47 prefectures. The number of laparoscopy‐qualified gynecologists correlated significantly with these regional disparities. The academic society should monitor these regional disparities and make an effort to reduce these regional disparities by increasing laparoscopy‐qualified gynecologists in areas where the widespread use of laparoscopic techniques is lagging.

The number of physicians is related to the number of nighttime emergency surgeries in Japan: An ecological study

“…Several reports have suggested an association between the number of physicians per population and the quality of medical services in the field of primary care [9][10][11][12]. However, there are not many reports related to the field of surgery [13,14]. Delay in emergency surgery is associated with adverse outcomes, such as in-hospital death, prolonged hospital stay, and increased hospitalization costs [15][16][17].…”