[Occupational health efforts and the state of preparation for the implementation of doctors' work-style reforms in medical institutions in the Kanto region (2023 survey)].

Abstract

Objectives: This study examined the status of occupational health activities in hospitals certified by the Japan Council for Quality Health Care in the Kanto region. Additionally, it sought to assess hospital preparedness for implementing doctor workstyle reforms, which were enacted in the fiscal year 2024.

Methods: Questionnaires were mailed to occupational health officers in 497 hospitals. The survey collected information on the number of beds, hospital functions, occupational health systems, infection control measures, mental health initiatives, measures against long working hours, and work style reforms.

Results: Responses were obtained from 205 (41%) hospitals. In the occupational health system, some hospitals have assigned their directors or board chairpersons as occupational physicians, thereby raising regulatory concerns. Only 85% of the hospitals held monthly health committee meetings, whereas 98% had a health committee in place. Workplace rounds were conducted more frequently in hospitals with more beds and were conducted regularly in 79% of the hospitals. Hospitals with more beds also received more occupational nurse participation. Infection control measures, including immune screening and vaccination for hepatitis B and rubella/measles, have been widely implemented. All hospitals administered COVID-19 vaccinations to staff members. Many hospitals have established consultation systems for occupational physicians on mental health initiatives; however, return-to-work interviews conducted by occupational physicians were significantly more common in hospitals with more beds, with statistical significance. Regarding doctors' workstyle reforms, hospitals with more beds were less likely to obtain Level A certification and more likely to obtain Level B or C certification. Most hospitals with Levels B and C certifications were general hospitals and better prepared to conduct face-to-face consultations with doctors who work long hours.

Conclusions: Occupational health activities in hospitals showed high implementation rates for legally required measures, such as the appointment of occupational physicians, the establishment of health committees, and infection control measures, regardless of hospital size. However, elements such as workplace rounds, face-to-face consultations with employees working long hours, return-to-work interviews with those recovering from mental illnesses, and doctor work-style reform measures had higher implementation rates in larger hospitals, thus indicating a disparity based on hospital size.