The impact of poly-physician on elderly people with multimorbidity.

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K10356
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58010:Medical management and medical sociology-related
• Research Institution: Keio University
• Principal Investigator: ANDO TAKAYUKI 慶應義塾大学, 医学部(信濃町), 助教 (30850705)
• Co-Investigator(Kenkyū-buntansha): 新井 康通 慶應義塾大学, 医学部(信濃町), 講師 (20255467)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 多疾患併存 / ケアの分断 / ポリドクター / ポリファーマシー

Outline of Final Research Achievements

The term "multimorbidity" refers to a state in which a single patient suffers from multiple chronic conditions. It has become a problem in our country as it faces an aging society. This study demonstrated that multimorbidity is also associated with the patient's subjective health. Moreover, the management of patients with multimorbidity is problematic due to the involvement of multiple physicians, a situation referred to as "polydoctoring." This research developed the definition and measurement methods of polydoctoring, showing its association with an increase in polypharmacy and healthcare costs. Additionally, the study exploratively investigated the relationship between polydoctoring and patient health outcomes, indicating that the association between mortality and polydoctoring could be influenced by the number of coexisting conditions.

Free Research Field

多疾患併存

Academic Significance and Societal Importance of the Research Achievements

本研究では医療レセプトデータから定期的に通院する医療機関数を計算する方法を確立し、Regularly Visited Facilitiy(RVF)というポリドクターの尺度を開発した。このRVFを用いることで、ポリドクターと健康アウトカムの関連を調査することが可能になった。実際にRVFが高くなると、ポリファーマシーの発生が増え、外来医療費も増加する傾向にあることがしめされた。また、ポリドクターが多疾患併存を抱える超高齢患者の死亡率とどのように関連しているかを明らかにすることで、外来において専門医への紹介を積極的にすべきか、包括的にかかりつけ医が診療すべきかという問いに対する答えを探索している。