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Researchers at University of Tsukuba report that collaboration between home healthcare institutions and private after-hours house-call (AHHC) services—which provide emergency responses during nighttime and holidays—can facilitate home visit care while improving physicians' job satisfaction and quality of life. This collaborative model may represent an effective strategy for supporting the sustainability of home healthcare, particularly in settings where a single physician is often required to remain on call 24 hours a day.

Tsukuba, Japan—Rapid population aging has substantially increased the demand for home healthcare services in recent years, leading to the expansion of clinics and hospitals that provide round‑the‑clock care. However, many home healthcare institutions operate with only one physician, creating significant mental and physical burdens for providers who must respond to patient needs during nights and holidays.

In this study, researchers conducted a questionnaire survey among physicians working at home healthcare institutions that collaborated with a private AHHC service provider, Fast DOCTOR Ltd., to establish systems for nighttime and holiday responses. These systems include telephone consultations, house calls—defined as visits to patients' homes or residential facilities upon request—and triage decisions regarding the need for emergency transportation. The survey examined physicians' perceived advantages and disadvantages of such collaboration, as well as changes in working conditions and response patterns during nights and holidays before and after the collaboration. To maintain independence, the research team distributed and collected the questionnaires, and the AHHC service provider did not have access to individual responses.

The results indicated that, compared with the period before collaboration, the frequency of nighttime and holiday house calls increased. In addition, a larger proportion of medical institutions reported that they attempted to make emergency house calls whenever possible in urgent situations. Conversely, the proportion of institutions that frequently instructed visiting nurses to respond or that advised patients to call an ambulance or visit an emergency department decreased.

From the physicians' perspective, many respondents reported reduced mental and physical burdens associated with nighttime and holiday house calls and noted that scheduling during these periods became easier. Physicians' job satisfaction and quality of life (QOL) increased significantly after collaboration, while fatigue levels also showed significant improvement. However, approximately half of the respondents reported an increased burden related to sharing patient information, highlighting the administrative workload associated with information exchange as a continuing challenge.

Overall, the findings suggest that collaboration with AHHC services can strengthen nighttime and holiday home visit systems while improving physicians' job satisfaction and QOL . These results provide important insights for developing sustainable home healthcare delivery systems. Nevertheless, the burden associated with patient information sharing remains an issue that warrants further investigation.

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This research was funded by Fast DOCTOR Ltd.

Original Paper

Title of original paper:

Physician-reported outcomes associated with collaboration between home healthcare institutions and after-hours house-call services in Japan

Journal:

BMC Primary Care

DOI:

10.1186/s12875-025-03120-5

Correspondence

Professor TAMIYA Nanako
Specially Appointed Assistant Professor Yu Sun
Health Services Research and Development Center / Institute of Medicine, University of Tsukuba

Related Link

Institute of Medicine
Department of Health Services Research, Institute of Medicine