The characteristics of general practitioners and geriatricians who take overall responsibility for the care of older patients with multimorbidity

Abstract

Background

Older patients with multimorbidity often seek care from multiple health care providers and visit several medical institutions. Having a primary care provider who takes overall responsibility for their care may be beneficial. We conducted a survey to identify the characteristics of general practitioners and geriatricians who frequently assume such responsibility for older patients with multimorbidity.

Methods

In June 2022, we distributed by mail an anonymous questionnaire to 3300 family medicine specialists, primary care-certified physicians, and geriatric specialists in Japan. We used a four-point Likert-type scale to score items related to conditions and patient backgrounds that pose challenges in treatment, key clinical factors, and important clinical strategies. Modified Poisson regression was used to identify factors associated with frequently assuming overall responsibility for medical care.

Results

Data from 746 physicians were included in the analysis. Factors associated with frequently assuming overall responsibility for medical care of older patients with multimorbidity included providing inpatient ward care (prevalence ratio [PR] 1.237, 95% CI 1.124–1.362), providing home medical care (PR 1.357, 95% CI 1.225–1.504), frequently treating patients over 90 years old (PR 2.043, 95% CI 1.258–3.318), and the overall score for clinical strategies (PR 1.021, 95% CI 1.010–1.033).

Conclusions

General practitioners and geriatricians who frequently assume overall responsibility for the care of older patients with multimorbidity tend to engage significantly in ward and home medical care, often treat patients above 90 years, and employ numerous clinical strategies.