Evidence map›Paper›PMID 40347438›Full record

ArticleFamily practice2025

The extent and improvement of patient complexity in referrals to hospital family physicians from community healthcare-related centers in Japan: a retrospective cohort study.

Junki Mizumoto, Yumiko Hironaka, Hirohisa Fujikawa

Abstract read
In one paragraph

Article in Family practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Junki MizumotoCenter for General Medicine Education, School of Medicine, Keio University, Tokyo, Japan.ORCID 0000-0002-0783-7351
Yumiko HironakaRegional medical coordination office, Ehime Seikyo Hospital, Matsuyama, Japan.
Hirohisa FujikawaCenter for General Medicine Education, School of Medicine, Keio University, Tokyo, Japan.ORCID 0000-0002-8195-1267

Funding

KAKENHI 24K23757
6 · The paper itself

Abstract

backgroundHospital family physicians are recognized for their excellence in managing complex issues. This study aimed to reveal the level of complexities of patients referred to hospital family physicians by community centers, and the degree of change in these complexities following care provided by a health care team that includes hospital family physicians.

methodsA retrospective cohort analysis. Patients introduced by community centers between 2020 and 2023 were identified. The patients received team-based comprehensive care. Complexity was calculated before and after the care, using the patient-centered assessment method (PCAM), which evaluates 12 items across four domains. Each item is rated from 1 to 4, yielding a total score range of 12 to 48. Pre- and post-intervention scores were compared using paired-sample t-tests, with standardized mean difference calculated using Hedges' g.

resultsOf 41 referred patients, three died shortly after the initial consultation. Among the 38 remaining patients, 24 were admitted, and 14 were treated as outpatients. The mean PCAM score significantly decreased from 36.9 to 23.7 after interventions (P < .001, Hedges' g = 2.54). Scores improved significantly across all domains: health and well-being (2.96 vs 1.95; P < .001, g = 2.00), social environment (3.09 vs 1.96; P < .001, g = 2.38), health literacy and communication (2.78 vs 2.46; P < .001, g = 0.67), and service coordination (3.61 vs 1.57; P < .001, g = 4.68).

conclusionHospital family physicians in Japan often manage patients with exceptionally complex problems and improve patient outcomes across multiple domains.

Indexed as

Community Health CentersPhysicians, FamilyReferral and ConsultationAdultAgedFemaleHumansJapanMaleMiddle AgedPatient-Centered CareRetrospective Studiesdelivery of health carefamily medicinegeriatricspatient-centered care

Identifiers

PMID40347438
PMCPMC12445869

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.