Abstract
BackgroundIn Japan, which has the most rapidly aging population worldwide, the number of geriatric health service facilities (GHSFs) has been increasing. GHSF physicians play significant roles in integrated care for the elderly. However, little is known about the temporal trends of physicians working in GHSFs.ObjectivesWe aim to examine temporal trends in the characteristics of GHSF physicians and identify physician factors associated with starting work at GHSFs.DesignCohort study.Setting and participantsPhysicians responding to biennial national physician census surveys conducted by the Ministry of Health, Labour and Welfare of Japan from 1996 to 2016. The response rate was approximately 90%.MethodsWe estimated temporal trends in the number, proportion, and characteristics of GHSF physicians. A multivariable logistic regression analysis identified physician factors associated with starting work at GHSFs 10 years after 1996–2006 and 2006–2016 among physicians not working in GHSFs at baseline (1996 and 2006).ResultsGHSF physicians rapidly increased in the first decade from 1,127 (0.47%) in 1996 to 2,891 (1.04%) in 2006; this trend then slowed and was almost proportional to that of all physicians, reaching 3,345 (1.05%) in 2016. GHSF physicians aged ≥65 years increased from 61.2% in 1996 to 68.5% in 2016, while those aged <40 years decreased from 13.8% to 1.9%. The sex ratio (male vs. female physicians) increased from 5.7 in 1996 to 6.4 in 2016. Physician factors associated with starting to work at GHSFs included older age, female sex, rural area, working at hospitals, and majored in internal medicine and surgery specialties.ConclusionsThe proportion of GHSF physicians among all physicians has stagnated, and GHSF physicians are aging. Facilitating the transition of younger physicians from clinical practice in hospitals to GHSFs will increase the number of GHSF physicians and improve the quality of care in GHSFs.
Highlights
Population aging is one of the most important public health issues worldwide
geriatric health service facilities (GHSFs) physicians aged 65 years increased from 61.2% in 1996 to 68.5% in 2016, while those aged
Facilitating the transition of younger physicians from clinical practice in hospitals to GHSFs will increase the number of GHSF physicians and improve the quality of care in GHSFs
Summary
Owing to decreasing birth rates and increasing life expectancy, the Japanese population has been aging rapidly in recent decades. In Japan, geriatric health service facilities (GHSFs) were first established in 1987 under the Health Service Law for the Aged. They provide temporal intermediate care, which includes medical and welfare services, for elderly individuals when they need rehabilitation before returning home from the hospital [2, 3]. People are admitted to GHSFs from the hospital after their acute medical conditions become stable, and they stay until they are ready to return home [4]. In Japan, which has the most rapidly aging population worldwide, the number of geriatric health service facilities (GHSFs) has been increasing. Editor: Chun Chieh Yeh, China Medical University Hospital, TAIWAN Received: September 13, 2020 Accepted: April 11, 2021
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