Increased number of Judo therapy facilities in Japan and changes in their geographical distribution

Satoshi Inoue,Kyoko Nomura,Mutsuhiro Nakao,Eiji Yano

doi:10.1186/1472-6963-11-48

Abstract

BackgroundJudo therapy is a well established Japanese co-medical profession specializing in outpatient manual treatment of fractures and sprains. Recently, the number of judo therapists has been rapidly increasing as a result of proliferation judo therapy academies. This study examines whether such rapid increases have improved geographical distribution of judo therapy facilities in Japan.MethodsThe number of judo therapy facilities and the population in each municipality were obtained from the Web yellow pages and from Japanese census data for 2004, 2006, and 2008, respectively. Lorenz curves and Gini indices were calculated to demonstrate distributions of judo therapy facilities per 100,000 people. A bootstrapped method was used to identify statistical significances of differences in Gini indices.ResultsIn all municipalities, the mean numbers of judo therapy facilities per 100,000 people were 15.3 in 2004, 15.8 in 2006, and 17.6 in 2008. The Gini indices for judo therapy facilities nationally were 0.273 in 2004, 0.264 in 2006, and 0.264 in 2008. The numbers of judo therapy facilities increased significantly between 2006 and 2008 (p < 0.05) but the indices did not change significantly in the same period. The Gini indices for local towns and villages remained unchanged and were consistently higher (p < 0.05) than those in urban areas throughout the study periods.ConclusionOur results suggest that recent increases in the number of judo therapy facilities have not necessarily led to greater equality in their geographic distribution in terms of Gini indices.

Highlights

Judo therapy is a well established Japanese co-medical profession specializing in outpatient manual treatment of fractures and sprains
If the increased number of judo therapists were concentrated primarily in urban areas, which contain a relatively large number of orthopedists, the overlapping services provided by both professions might lead to conflicts between them
To perform the same type of analysis to assess disproportionate distributions of judo therapy facilities, we developed our database of the number of judo therapy facilities in each Japanese municipality and have published two reports on the geographic density of judo therapists [14,15]

Summary

Introduction

Judo therapy is a well established Japanese co-medical profession specializing in outpatient manual treatment of fractures and sprains. Judo therapists are expected to provide complementary and alternative medical treatments, in areas with insufficient medical care services. In this sense, assessing the geographic distribution of judo therapists is important. If the increased number of judo therapists were concentrated primarily in urban areas, which contain a relatively large number of orthopedists, the overlapping services provided by both professions might lead to conflicts between them. For the current increased numbers of judo therapists to provide their services more equitably in terms of geographic distribution would be preferable, but no published studies have examined this possibility

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Results

Conclusion