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Research article
Hiroyoshi Iwata
Tokyo Jikeikai Ika Daigaku
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6949-0795
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Background Due to the fact that Japan faces the most elderly society in the world, the Japanese government has launched an unprecedented health plan to reinforce home care medicine and increase the number of home care physicians, which means that an understanding of future needs for geriatric home care is vital. However, little is known about the future need for home care physicians. We attempted to estimate the basic need for home care physicians from 2020 to 2060.
Methods Our estimation is based on modification of major health work force analysis methods with previously reported official data. Two models were developed to estimate the necessary number of full-time equivalent (FTE) home care physicians: one based on home care patient mortality, the other using physician-to-patient ratio, working with estimated numbers of home and nursing home deaths from 2020 to 2060. Moreover, the final process considered and adjusted for future changes in the proportion of patients dying at home. Lastly, we converted estimated FTE physicians to an estimated head count.
Results Results were concordant between our two models. In every instance, there was overlap of high- and low-estimations between the mortality method and the physician-to-patient method, and the estimates show highly similar patterns.Furthermore, our estimation is supported by the current number of physicians, which was calculated using a different method. Approximately 1.7 times (1.6 by head count) the current number of FTE home care physicians will be needed in Japan in the late 2030’s, peaking at 33,500 FTE (71,500 head count). However, the need for home care physicians is anticipated to begin decreasing by 2040.
Conclusion The results indicate that the importance of home care physicians will rise with the growing elderly population, and that improvements in home care could partially suppress future need for physicians. After the late 2030’s, the supply can be reduced gradually, accounting for the decreasing total number of deaths after 2040. In order to provide sufficient home care and terminal care at home, increasing the number of home care physicians is indispensable. However, the unregulated supply of home care physicians will require careful attention in the future.
Keywords
home care medicine, aged society, health care workforce, future prediction analysis
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Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 13 Aug, 2020
Published
On 15 Aug, 2020
No community comments so far
Editorial decision: Accept
On 30 Jul, 2020
Review #1 received
Received 27 Jul, 2020
Reviewer #1 agreed
On 05 Jul, 2020
Reviewers invited
Invitations sent on 29 Jun, 2020
Editor assigned
On 26 Jun, 2020
Submission checks complete
On 25 Jun, 2020
Editor invited
On 25 Jun, 2020
No comments provided
Review #2 received
Received 21 May, 2020
Editorial decision: Major revision
On 21 May, 2020
Reviewer #2 agreed
On 18 Dec, 2019
Review #1 received
Received 26 Sep, 2019
Reviewers invited
Invitations sent on 26 Sep, 2019
Reviewer #1 agreed
On 26 Sep, 2019
Editor assigned
On 04 Sep, 2019
Submission checks complete
On 28 Aug, 2019
Editor invited
On 28 Aug, 2019
First submitted
On 15 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
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This preprint is under consideration at BMC Health Services Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Hiroyoshi Iwata
Tokyo Jikeikai Ika Daigaku
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6949-0795
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 13 Aug, 2020
Published
On 15 Aug, 2020
No community comments so far
Editorial decision: Accept
On 30 Jul, 2020
Review #1 received
Received 27 Jul, 2020
Reviewer #1 agreed
On 05 Jul, 2020
Reviewers invited
Invitations sent on 29 Jun, 2020
Editor assigned
On 26 Jun, 2020
Submission checks complete
On 25 Jun, 2020
Editor invited
On 25 Jun, 2020
No comments provided
Review #2 received
Received 21 May, 2020
Editorial decision: Major revision
On 21 May, 2020
Reviewer #2 agreed
On 18 Dec, 2019
Review #1 received
Received 26 Sep, 2019
Reviewers invited
Invitations sent on 26 Sep, 2019
Reviewer #1 agreed
On 26 Sep, 2019
Editor assigned
On 04 Sep, 2019
Submission checks complete
On 28 Aug, 2019
Editor invited
On 28 Aug, 2019
First submitted
On 15 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Background Due to the fact that Japan faces the most elderly society in the world, the Japanese government has launched an unprecedented health plan to reinforce home care medicine and increase the number of home care physicians, which means that an understanding of future needs for geriatric home care is vital. However, little is known about the future need for home care physicians. We attempted to estimate the basic need for home care physicians from 2020 to 2060.
Methods Our estimation is based on modification of major health work force analysis methods with previously reported official data. Two models were developed to estimate the necessary number of full-time equivalent (FTE) home care physicians: one based on home care patient mortality, the other using physician-to-patient ratio, working with estimated numbers of home and nursing home deaths from 2020 to 2060. Moreover, the final process considered and adjusted for future changes in the proportion of patients dying at home. Lastly, we converted estimated FTE physicians to an estimated head count.
Results Results were concordant between our two models. In every instance, there was overlap of high- and low-estimations between the mortality method and the physician-to-patient method, and the estimates show highly similar patterns.Furthermore, our estimation is supported by the current number of physicians, which was calculated using a different method. Approximately 1.7 times (1.6 by head count) the current number of FTE home care physicians will be needed in Japan in the late 2030’s, peaking at 33,500 FTE (71,500 head count). However, the need for home care physicians is anticipated to begin decreasing by 2040.
Conclusion The results indicate that the importance of home care physicians will rise with the growing elderly population, and that improvements in home care could partially suppress future need for physicians. After the late 2030’s, the supply can be reduced gradually, accounting for the decreasing total number of deaths after 2040. In order to provide sufficient home care and terminal care at home, increasing the number of home care physicians is indispensable. However, the unregulated supply of home care physicians will require careful attention in the future.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
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