Ishikawa Masatoshi, Iwagami Masao, Tamiya Nanako
Takemi Program in International Health, Harvard T.H. Chang School of Public Health, Boston, Massachusetts, United States of America.
Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
PLoS One. 2021 Apr 27;16(4):e0250589. doi: 10.1371/journal.pone.0250589. eCollection 2021.
In 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.
We aim to examine temporal trends in the characteristics of GHSF physicians and identify physician factors associated with starting work at GHSFs.
Cohort study.
Physicians 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%.
We 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).
GHSF 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.
The 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.
在全球老龄化速度最快的日本，老年保健服务设施（GHSF）的数量一直在增加。GHSF医生在老年人的综合护理中发挥着重要作用。然而，对于在GHSF工作的医生的时间趋势了解甚少。
我们旨在研究GHSF医生特征的时间趋势，并确定与开始在GHSF工作相关的医生因素。
队列研究。
对日本厚生劳动省1996年至2016年每两年进行一次的全国医生普查调查做出回应的医生。回应率约为90%。
我们估计了GHSF医生的数量、比例和特征的时间趋势。多变量逻辑回归分析确定了在基线（1996年和2006年）不在GHSF工作的医生中，与1996 - 2006年和2006 - 2016年10年后开始在GHSF工作相关的医生因素。
在第一个十年中，GHSF医生数量迅速增加，从1996年的1127名（0.47%）增至2006年的2891名（1.04%）；随后这一趋势放缓，且几乎与所有医生的增长趋势成比例，到2016年达到3345名（1.05%）。65岁及以上的GHSF医生从1996年的61.2%增至2016年的68.5%，而40岁以下的医生则从13.8%降至1.9%。性别比（男医生与女医生）从1996年的5.7增至2016年的6.4。与开始在GHSF工作相关的医生因素包括年龄较大、女性、农村地区、在医院工作以及主修内科和外科专业。
GHSF医生在所有医生中的比例停滞不前，且GHSF医生正在老龄化。促进年轻医生从医院临床实践向GHSF的转变将增加GHSF医生的数量，并提高GHSF的护理质量。
