Death at home versus other locations in older people receiving physician-led home visits: A multicenter prospective study in Japan.

Background: The Japanese government is promoting physician-led home visits as well as end-of-life care at home. However, the proportion of deaths occurring at home has remained unchanged for the past 20 years.

Objectives: To report the cumulative incidence of deaths at home and to explore the factors associated with deaths at home versus other places, mainly hospitals.

Use of a 2-year continuing professional development programme to change Japanese physicians' attitudes to learning primary care: a qualitative study.

Objective: To evaluate changes in the learning attitudes of primary care physicians.

Design: Qualitative study through one focus group interview with the programme's participants. Analysis of the focus group content using the Steps for Coding and Theorization method.

Patient experience of residents with restricted primary care access during the COVID-19 pandemic.

Objectives: To evaluate primary care access for COVID-19 consultation among residents who have a usual source of care (USC) and to examine their associations with patient experience during the pandemic in Japan.

Design: Nationwide cross-sectional study.

Setting: Japanese general adult population.

Usual source of primary care and preventive care measures in the COVID-19 pandemic: a nationwide cross-sectional study in Japan.

Objectives: To assess multiple preventive care measures and to examine their associations with having a usual source of primary care and primary care performance during the COVID-19 pandemic in Japan.

Design: Nationwide cross-sectional study.

Setting: Japanese general adult population.

Associations of primary care structures with polypharmacy and patient-reported indicators in patients with complex multimorbidity: a multicentre cross-sectional study in Japan.

Objectives: Evidence supporting the effects of primary care structures on the quality of care for patients with complex multimorbidity, which is one of the most important challenges facing primary care, is scarce internationally. This study aimed to examine the associations of the types of primary care facilities with polypharmacy and patient-reported indicators in patients with complex multimorbidity, with a focus on differences between community clinics and hospitals.

Design: Multicentre cross-sectional study.

Effect of multimorbidity patterns on the decline in health-related quality of life: a nationwide prospective cohort study in Japan.

Objectives: Longitudinal studies, which consider multimorbidity patterns, are useful for better clarifying the effect of multimorbidity on health-related quality of life (HRQoL) and for identifying the target population with poorer clinical outcomes among patients with multimorbidity. This study aimed to examine the effects of different multimorbidity patterns on the decline in HRQoL.

Design: Nationwide prospective cohort study.

Overall mortality in older people receiving physician-led home visits: a multicentre prospective study in Japan.

Background: Japan has the most rapidly ageing population in the world. The Japanese government has, therefore, promoted physician-led home health care for frail and disabled people.

Objectives: To describe mortality among older people receiving physician-led health care at home or at a nursing home in Japan and to identify risk factors.

Perspectives on expert generalist practice among Japanese family doctor educators: a qualitative study.

Background: Expert generalist practice (EGP) is increasingly being viewed as the defining expertise of generalist care. In Japan, several prominent family doctors consider it important and relevant in the Japanese context. However, no study has examined Japanese family doctor educators' perceptions of EGP.

The need for home care physicians in Japan - 2020 to 2060.

Background: Japan faces the most elderly society in the world, and 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.

How a problem-based learning approach could help Japanese primary care physicians: a qualitative study.

Objectives: This study aimed to identify training needs among primary care physicians in Japan who had no formal primary care training.

Methods:  We conducted a focus group interview with seven Japanese primary care physicians who had not previously undergone specialist training in primary care and had been recruited to a family medicine training program that used a problem-based learning approach. At the start of the program, the physicians attended the interview.

Correlation of patient complexity with the burden for health-related professions, and differences in the burden between the professions at a Japanese regional hospital: a prospective cohort study.

Objectives: An ageing society includes high patient complexity. Various biopsychosocial problems result in a high burden for health-related professionals. The direct relationship between the burden and patient complexity, however, has not been reported.

Combining Scores Based on Compensatory and Noncompensatory Scoring Rules to Assess Resident Readiness for Unsupervised Practice: Implications From a National Primary Care Certification Examination in Japan.

Purpose: Competence decisions in health professions education require combining scores from multiple sources and identifying pass-fail decisions based on noncompensatory (required to pass all subcomponents) and compensatory scoring decisions. This study investigates consequences of combining scores, reliability, and implications for validity using a national examination with subcomponent assessments.

Method: National data were used from three years (2015, 2016, and 2017) of the Japan Primary Care Association Board Certification Examination, with four subcomponent assessments: Clinical Skills Assessment-Integrated Clinical Encounter (CSA-ICE), CSA-Communication and Interpersonal Skills (CSA-CIS), Multiple-Choice Questions (MCQ), and Portfolio.

Social Isolation and Patient Experience in Older Adults.

Purpose: Social isolation has been identified as a major health problem, particularly in the elderly. In the present study, we examine the association between social isolation and patient experience in elderly primary care patients.

Methods: This cross-sectional study was conducted in a primary care practice-based research network (28 clinics) in Japan.

Effect of Patient Experience on Bypassing a Primary Care Gatekeeper: a Multicenter Prospective Cohort Study in Japan.

Background: To discuss how best to implement the gatekeeping functionality of primary care; identifying the factors that cause patients to bypass their primary care gatekeepers when seeking care should be beneficial.

Objective: To examine the association between patient experience with their primary care physicians and bypassing them to directly obtain care from higher-level healthcare facilities.

Design And Methods: This prospective cohort study was conducted in 13 primary care clinics in Japan.

Validity and reliability of the Patient Centred Assessment Method for patient complexity and relationship with hospital length of stay: a prospective cohort study.

Objectives: Several instruments for evaluating patient complexity have been developed from a biopsychosocial perspective. Although relationships between the results obtained by these instruments and the length of stay in hospital have been examined, many instruments are complicated and not easy to use. The Patient Centred Assessment Method (PCAM) is a candidate for practical use.

Attributes of primary care in relation to polypharmacy: a multicenter cross-sectional study in Japan.

Objective: To investigate the association between attributes of primary care and polypharmacy.

Design: Cross-sectional study.

Setting: A primary care practice-based research network in Japan (28 primary care clinics).

Patient experience of primary care and advance care planning: a multicentre cross-sectional study in Japan.

Background: Advance care planning (ACP) is becoming increasingly important in the primary care setting because of its positive impact on the end-of-life care.

Objective: We aimed to investigate the relationship between patient experience of primary care and ACP.

Methods: This cross-sectional study was conducted in 28 primary care clinics in Japan.

Psychological impact of lifestyle-related disease disclosure at general checkup: a prospective cohort study.

Background: Little is known about psychological impact of disclosing lifestyle-related diseases. Previous studies discussed the long-term psychological impact of disease disclosure, and a significant psychological impact was not observed. This study clarified the psychological impact on anxiety state of patients when lifestyle-related diseases are disclosed at general checkups for local residents.

Prospective cohort study of fever incidence and risk in elderly persons living at home.

Objective: To determine the incidence of fever among elderly persons under home medical management, diagnosis at fever onset and outcomes from a practical standpoint.

Design: Prospective cohort study.

Setting: 5 clinics in residential areas of Tokyo that process an average of 50-200 outpatients/day.

Retrospective cohort study of the incidence and risk of fever in elderly people living at home: a pragmatic aspect of home medical management in Japan.

Aim: In Japan, many elderly patients are managed at home, and fever is a common problem. This study examined the incidence of fever events in elderly patients on home medical management, and underlying disorders from the pragmatic standpoint. This study also investigated whether the care-need level determined at the start of home care predicts fever onset.

Two principal components, coping and independence, comprise patient enablement in Japan: cross sectional study in Tohoku area.

The concept of "patient enablement" involves patients' perceptions of ability to understand and cope with illness. Improving enablement is an important goal of medical consultations for patients with chronic illness. To measure "enablement," a post-medical-consultation patient-reported questionnaire was developed and named "Patient Enablement Instrument (PEI)" in the United Kingdom.

Patient autonomy preferences among hypertensive outpatients in a primary care setting in Japan.

Objectives: To investigate autonomy preferences and the factors to promote active patient participation in a primary care setting in Japan.

Patients: Ninety-two hypertensive outpatients who consecutively visited a Japanese hospital between January and May of 2005 in Tokyo, Japan.

Methods: This cross-sectional study was conducted by using a self-administered questionnaire.