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Background: Judo 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., Methods: The 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., Results: In 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., Conclusion: Our 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.

Objective: Judo therapy originally developed from manual treatment of bone and joint injury by judo athletes and nowadays has become a popular alternative and complementary medicine in the area of orthopedic care. The purpose of the present study was to assess the relationships of judo therapists and orthopedic physicians as health service providers by comparing geographical distributions of their two types of facilities., Study Design: A cross-sectional study., Methods: The numbers of judo therapist facilities and orthopedic facilities per 100,000 population in each municipality were obtained through web yellow pages and from Japanese census data. In order to investigate the geographical distributions of these facilities according to cities, towns and villages, Lorenz curves were drawn and Gini indices were calculated., Results: Judo therapist facilities were more ubiquitously located than orthopedic facilities: the median number of judo therapist facilities per 100,000 population in all municipalities (n = 1949) was 14.9 (25-75 percentile: 8.6-21.8) and that of orthopedic facilities was 2.8 (0-51.9). The number of municipalities without judo therapist facilities was 322 while that for those without orthopedic facilities was 822. There were 231 municipalities without orthopedic facilities but with judo therapist facilities, while there were only 18 municipalities without judo therapist facilities but with orthopedic facilities. The overall Gini indices ofjudo therapist facilities and orthopedic facilities were 0.264 and 0.276, respectively. When the differences in Gini indices between judo therapist facilities and orthopedic facilities were separately compared in cities, towns and villages, those in cities were 0.247 and 0.232, respectively, while those in towns and villages were 0.403 and 0.632, respectively., Conclusion: Comparing the geographical distribution of the two types of health care facilities, orthopedic facilities were found to be more frequently located in cities than in towns and villages whereas judo therapist facilities appeared to be more homogeneously located. It is suggested that judo therapist facilities may thus fill some of the need for orthopedic care, especially in rural areas.

To describe the characteristics of monitoring stations for the infectious disease surveillance system in Japan, we compared the distributions of the number of monitoring stations in terms of population, region, size of medical institution, and medical specialty. The distributions of annual number of reported cases in terms of the type of diseases, the size of medical institution, and medical specialty were also compared. We conducted a nationwide survey of the pediatrics stations (16 diseases), ophthalmology stations (3 diseases) and the stations of sexually transmitted diseases (STD) (5 diseases) in Japan. In the survey, we collected the data of monitoring stations and the annual reported cases of diseases. We also collected the data on the population, served by the health center where the monitoring stations existed, from the census. First, we compared the difference between the present number of monitoring stations and the current standard established by the Ministry of Health and Welfare (MHW). Second, we compared the distribution of all medical institutions in Japan and the monitoring stations in terms of the size of the medical institution. Third, we compared the average number of annual reported cases of diseases in terms of the size of medical institution and the medical specialty. In most health centers, the number of monitoring stations achieved the current standard of MHW, while a few health centers had no monitoring station, although they had a large population. Most prefectures also achieved the current standard of MHW, but some prefectures were well below the standard. Among pediatric stations, the sampling proportion of large hospitals was higher than other categories. Among the ophthalmology stations, the sampling proportion of hospitals was higher than other categories. Among the STD stations, the sampling proportion of clinics of obstetrics and gynecology was lower than other categories. Except for some diseases, it made little difference in the average number of annual reported cases of diseases in terms of the type of medical institution. Among STD, there was a great difference in the average number of annual reported cases of diseases in terms of medical specialty.