Aging of Large Cities and Medical and Nursing Care Issues: Estimate of Future Numbers of Doctors and Hospital Beds and Future Facility Capacity Based on Trend Data

The purpose of this study is to grasp the current status of nursing care, particularly in large cities, by identifying changes in the numbers of doctors and general hospital beds and the capacity of nursing care facilities in the past 10 years and to forecast future numbers. In order to look at changes in the numbers of doctors and general hospital beds in each secondary medical care area in the past 10 years amid the drastic change in the area demarcation following the major consolidation of municipalities, we recalibrated the data for 2004 in line with the demarcation of the secondary medical areas in 2014 and calculated the numbers of doctors and general hospital beds in 2004 and 2014 in each area. In addition, we estimated the supply of facilities for elderly people in 2025 based on changes in the facility capacity between 2014 and 2016. At the same time, we estimated an excess or shortage of facilities for elderly people by region in 2025 by multiplying the estimated number of people aged 75 or older by the ratio of the capacity of such facilities to the number of people aged 75 or older in 2015 (0.081). As a result, it was found that in the whole of Japan, the number of doctors increased 15% during the 10 years from 2004 to 2014, while the number of hospital beds decreased 7%. In large cities, the number of doctors increased remarkably but the number of hospital beds declined slightly. In the Tokyo metropolitan area and Fukuoka in particular, the increase in the number of doctors was prominent and the number of doctors per bed also rose steeply. Concerning facilities for elderly people, the capacity of facilities for elderly people recorded an increase matching the growth in the number of people aged 75 or older only in the Tokyo metropolitan area. On the other hand, in other large cities, the increase in the capacity of facilities for elderly people did not keep pace with the growth in the number of people aged 75 or older. If the current situation continues, it is highly likely that the capacity of facilities for elderly people will fall far short of the necessary capacity, resulting in a steep rise in the number of elderly people with nowhere to go in order to receive nursing care.