Characteristics of physicians working at geriatric health service facilities in Japan, 1996–2016

BACKGROUND: 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. OBJECTIVES: We aim to examine temporal trends in the characteristics of GHSF physicians and identify physician factors associated with starting work at GHSFs. DESIGN: Cohort study. SETTING AND PARTICIPANTS: 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%. METHODS: 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). RESULTS: 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. CONCLUSIONS: 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.