Physician-reported outcomes associated with collaboration between home healthcare institutions and after-hours house-call services in Japan.

Abstract

BACKGROUND: In Japan, home healthcare is a system in which physicians regularly visit patients at home to provide medical care. Additionally, the physicians are required to be available for 24-hour emergency home visits upon patient request. However, numerous single-physician home healthcare providers have been overburdened, particularly with after-hours consultations. This study aimed to examine physicians’ perceptions of changes associated with collaboration between medical institutions providing home healthcare and after-hours house-call (AHHC) services. METHODS: A questionnaire survey was conducted in 57 clinics and hospitals providing home healthcare that began collaborating with AHHC providers in Japan between January 2021 and September 2022. This study analyzed the changes in the management of after-hours consultations by healthcare providers before and after collaboration, along with its advantages and drawbacks. Furthermore, we also compared job satisfaction, workload, quality of life (QOL), and fatigue before and after collaboration, using the Wilcoxon signed-rank test to determine changes in each scale. RESULTS: The study included 25 physicians from 21 institutions, with a response rate of 37%. The percentage of home visits for after-hours consultations increased after collaboration. While 56–88% (16–22/25) of physicians noted that the mental and physical burden of AHHC was reduced, 48% (12/25) of physicians noted an increase in the burden of sharing patient information. The results revealed physicians perceived improvements in job satisfaction (p = 0.015), QOL (p = 0.026), and fatigue (p = 0.015) after collaboration; however, there was no significant change in workload (p = 0.209). CONCLUSION: Our findings indicate that physicians perceived improvements in job satisfaction and QOL and reduced fatigue after the collaboration with AHHC services. However, this result also suggests that it is necessary to simplify the sharing of patient information and reduce the burden of collaboration.