National Medical Care System May Impede Fostering of True Specialization of Radiation Oncologists: Study Based on Structure Survey in Japan

Journal Article · Sun Jan 01 04:00:00 EST 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2011.01.029· OSTI ID:22055985

Numasaki, Hodaka ^[1]; Shibuya, Hitoshi ^[2]; Nishio, Masamichi ^[3]; Ikeda, Hiroshi ^[4]; Sekiguchi, Kenji ^[5]; Kamikonya, Norihiko ^[6]; Koizumi, Masahiko ^[7]; Tago, Masao ^[8]; Ando, Yutaka ^[9]; Tsukamoto, Nobuhiro ^[10]; Terahara, Atsuro ^[11]; Nakamura, Katsumasa ^[12]; Mitsumori, Michihide ^[13]; Nishimura, Tetsuo ^[14]; Hareyama, Masato ^[15]; Teshima, Teruki ^[1]

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1. Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka (Japan)
2. Department of Radiology, Tokyo Medical and Dental University, Tokyo (Japan)
3. Department of Radiology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Hokkaido (Japan)
4. Department of Radiology, Sakai Municipal Hospital, Sakai, Osaka (Japan)
5. Department of Radiation Oncology, St. Luke's International Hospital, Tokyo (Japan)
6. Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo (Japan)
7. Oncology Center, Osaka University Hospital, Suita, Osaka (Japan)
8. Department of Radiology, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kawasaki, Kanagawa (Japan)
9. Department of Medical Informatics, Heavy Ion Medical Center, National Institute of Radiological Sciences, Chiba (Japan)
10. Department of Radiation Oncology, Saitama Medical University International Medical Center, Saitama (Japan)
11. Department of Radiology, Toho University Omori Medical Center, Tokyo (Japan)
12. Department of Radiology, Kyushu University Hospital at Beppu, Oita (Japan)
13. Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine Kyoto University, Kyoto (Japan)
14. Division of Radiation Oncology, Shizuoka Cancer Center, Shizuoka (Japan)
15. Department of Radiology, Sapporo Medical University, Hokkaido (Japan)

Purpose: To evaluate the actual work environment of radiation oncologists (ROs) in Japan in terms of working pattern, patient load, and quality of cancer care based on the relative time spent on patient care. Methods and Materials: In 2008, the Japanese Society of Therapeutic Radiology and Oncology produced a questionnaire for a national structure survey of radiation oncology in 2007. Data for full-time ROs were crosschecked with data for part-time ROs by using their identification data. Data of 954 ROs were analyzed. The relative practice index for patients was calculated as the relative value of care time per patient on the basis of Japanese Blue Book guidelines (200 patients per RO). Results: The working patterns of RO varied widely among facility categories. ROs working mainly at university hospitals treated 189.2 patients per year on average, with those working in university hospitals and their affiliated facilities treating 249.1 and those working in university hospitals only treating 144.0 patients per year on average. The corresponding data were 256.6 for cancer centers and 176.6 for other facilities. Geographically, the mean annual number of patients per RO per quarter was significantly associated with population size, varying from 143.1 to 203.4 (p < 0.0001). There were also significant differences in the average practice index for patients by ROs working mainly in university hospitals between those in main and affiliated facilities (1.07 vs 0.71: p < 0.0001). Conclusions: ROs working in university hospitals and their affiliated facilities treated more patients than the other ROs. In terms of patient care time only, the quality of cancer care in affiliated facilities might be worse than that in university hospitals. Under the current national medical system, working patterns of ROs of academic facilities in Japan appear to be problematic for fostering true specialization of radiation oncologists.

• OSTI ID: 22055985
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 82; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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