■ 学会名
NAPCRG annual meeting.

■ 発表日
2024/11/23

■ 筆頭演者
Takayuki Ando
Center for General Medicine Education, Keio University School of Medicine

■ 共同演者
Sasaki T¹, Haruta J², Arai Y¹
1) Center for Supercentenarian Medical Research, Keio University School of Medicine,
2) Center for General Medicine Education, Keio University School of Medicine

■ 発表形態
Oral

■ 要旨
This retrospective cohort study investigated the impact of polydoctoring—defined as receiving care from multiple regularly visited facilities (RVFs)—on hospital admission rates among older adults with multimorbidity in Japan. Using the DeSC claims database, the study included 2,547,456 individuals aged 75–89 years with at least two chronic conditions. The primary outcomes were all-cause hospital admissions and admissions for ambulatory care-sensitive conditions (ACSCs) within one year. A Cox proportional hazards model was used, adjusting for age, sex, and Charlson Comorbidity Index.
Results showed that individuals with RVF=0 had the highest risk of both all-cause admissions (HR 2.77; 95% CI: 2.71–2.83) and ACSC admissions (HR 1.74; 95% CI: 1.62–1.87), compared to those with RVF=1. While higher RVF levels (≥5) were also associated with increased all-cause admissions (HR 1.46; 95% CI: 1.42–1.51), they showed a trend toward fewer ACSC admissions.
These findings suggest that polydoctoring may reduce preventable admissions but increase overall hospitalization risk, potentially due to fragmented care. Having no regular source of care was associated with the poorest outcomes, highlighting the importance of continuity in managing multimorbidity.