| Total (n = 959) | Not annexed to hospitals (n = 390) | Annexed to hospitals (n = 569) | P valuea | ||
|---|---|---|---|---|---|
| Areab | Kanto | 331 (34.5) | 154 (39.5) | 177 (31.1) | 0.007 |
| Hokkaido | 19 (2.0) | 8 (2.1) | 11 (1.9) | ||
| Tohoku | 54 (5.6) | 23 (5.9) | 31 (5.4) | ||
| Chubu | 179 (18.7) | 60 (15.4) | 119 (20.9) | ||
| Kansai | 188 (19.6) | 87 (22.3) | 101 (17.8) | ||
| Chugoku | 73 (7.6) | 26 (6.7) | 47 (8.3) | ||
| Shikoku | 24 (2.5) | 9 (2.3) | 15 (2.6) | ||
| Kyushu | 82 (8.6) | 21 (5.4) | 61 (10.7) | ||
| Okinawa | 9 (0.9) | 2 (0.5) | 7 (1.2) | ||
| Location of facilities | Ordinance-designated cities/special wards in Tokyo | 379 (39.5) | 219 (56.2) | 160 (28.1) | <0.001 |
| Public or private institutions | Public | 182 (19.0) | 15 (3.8) | 167 (29.3) | <0.001 |
| Number of employees | 1-10 | 219 (22.8) | 73 (18.7) | 146 (25.7) | <0.001 |
| 11-20 | 249 (26.0) | 69 (17.7) | 180 (31.6) | ||
| 21-40 | 270 (28.2) | 92 (23.6) | 178 (31.3) | ||
| >40 | 221 (23.0) | 156 (40.0) | 65 (11.4) | ||
| Providing inpatient care for patients with COVID-19 | Yes | 482 (50.3) | 4 (1.0) | 478 (84.0) | <0.001 |
| Providing outpatient care for patients with COVID-19 | Yes | 648 (67.6) | 125 (32.1) | 523 (91.9) | <0.001 |
| Number of beds | <100 | N/A | N/A | 72 (12.7) | N/A |
| 100-299 | N/A | N/A | 282 (49.6) | ||
| 300-499 | N/A | N/A | 146 (25.7) | ||
| ≥500 | N/A | N/A | 63 (11.1) | ||
| Unanswered | N/A | N/A | 6 (1.1) | ||
| Emergency care | No emergency care | N/A | N/A | 71 (12.5) | N/A |
| Primary | N/A | N/A | 100 (17.6) | ||
| Secondary or tertiary | N/A | N/A | 391 (68.7) | ||
| Unanswered | N/A | N/A | 7 (1.2) | ||
| Personnel recruitment for check-up facilities is independent of recruitment for annexed hospitals | No | N/A | N/A | 321 (56.4) | N/A |
| Yes | N/A | N/A | 243 (42.7) | ||
| Unanswered | N/A | N/A | 5 (0.9) | ||
| Personnel transfer between the check-up facility and the annexed hospital | No | N/A | N/A | 118 (20.7) | N/A |
| Yes | N/A | N/A | 447 (78.6) | ||
| Unanswered | N/A | N/A | 4 (0.7) | ||
| Negative financial impact in 2023 | Yes | 235 (24.5) | 83 (21.3) | 152 (26.7) | 0.065 |
| Employee resignations compared to the pre-pandemic period | Increased | 104 (10.8) | 20 (5.1) | 84 (14.8) | <0.001 |
| New recruits in 2023 compared to 2019 | Decreased | 123 (12.8) | 29 (7.4) | 94 (16.5) | <0.001 |
| Employees complain that COVID-19-related rules are too strict | Yes | 73 (7.6) | 17 (4.4) | 56 (9.8) | 0.003 |
| Negative impact on the mental health of check-up facility employees | Yes | 280 (29.2) | 90 (23.1) | 190 (33.4) | <0.001 |
| Some employees have difficulty working due to long COVID | Yes | 74 (7.7) | 27 (6.9) | 47 (8.3) | 0.523 |
| Organizational social gathering involving meals held in FY2019/FY2023 | FY2019: no FY2023: no | 224 (23.4) | 96 (24.6) | 128 (22.5) | 0.069 |
| FY2019: no FY2023: yes | 227 (23.7) | 91 (23.3) | 136 (23.9) | ||
| FY2019: yes FY2023: no | 273 (28.5) | 95 (24.4) | 178 (31.3) | ||
| FY2019: yes FY2023: yes | 235 (24.5) | 108 (27.7) | 127 (22.3) |
| Before vs after COVID-19 downgrade | After COVID-19 downgrade | ||||||
|---|---|---|---|---|---|---|---|
| Before (n = 959) | After (n = 959) | P valuea | Not annexed to hospitals (n = 390) | Annexed to hospitals (n = 569) | P valueb | ||
| Employees | |||||||
| Wearing masks at work | Compulsory | 951 (99.2) | 893 (93.1) | <0.001 | 345 (88.5) | 548 (96.3) | <0.001 |
| Recommended | 8 (0.8) | 62 (6.5) | 43 (11.0) | 19 (3.3) | |||
| Personal choice | 0 (0.0) | 4 (0.4) | 2 (0.5) | 2 (0.4) | |||
| Wearing masks during commuting | Compulsory | 771 (80.4) | 203 (21.2) | <0.001 | 68 (17.4) | 135 (23.7) | 0.002 |
| Recommended | 165 (17.2) | 538 (56.1) | 213 (54.6) | 325 (57.1) | |||
| Personal choice | 23 (2.4) | 218 (22.7) | 109 (27.9) | 109 (19.2) | |||
| Wearing masks indoors during personal time | Compulsory | 690 (71.9) | 101 (10.5) | <0.001 | 37 (9.5) | 64 (11.2) | <0.001 |
| Recommended | 230 (24.0) | 539 (56.2) | 191 (49.0) | 348 (61.2) | |||
| Personal choice | 39 (4.1) | 319 (33.3) | 162 (41.5) | 157 (27.6) | |||
| Taking COVID-19 tests when having a fever | Compulsory | 868 (90.5) | 438 (45.7) | <0.001 | 140 (35.9) | 298 (52.4) | <0.001 |
| Recommended | 68 (7.1) | 370 (38.6) | 178 (45.6) | 192 (33.7) | |||
| Personal choice | 23 (2.4) | 151 (15.7) | 72 (18.5) | 79 (13.9) | |||
| Number of days employees are not allowed to work after a COVID-19 infection | No restrictions | N/A | N/A | N/A | 12 (3.1) | 6 (1.1) | <0.001 |
| 5 days | N/A | N/A | 321 (82.3) | 396 (69.6) | |||
| 7 days | N/A | N/A | 48 (12.3) | 137 (24.1) | |||
| ≥10 days | N/A | N/A | 4 (1.0) | 22 (3.9) | |||
| Others | N/A | N/A | 5 (1.3) | 8 (1.4) | |||
| When family members are infected with COVID-19 | Employees are not allowed to work for a certain period | 901 (94.0) | 210 (21.9) | <0.001 | 70 (17.9) | 140 (24.6) | 0.045 |
| Employees are allowed to work if they are not sick | 57 (5.9) | 728 (75.9) | 310 (79.5) | 418 (73.5) | |||
| No restrictions | 1 (0.1) | 21 (2.2) | 10 (2.6) | 11 (1.9) | |||
| Organizational social gathering among employees involving meals (hospital-wide year-end party, department-wide farewell party) | Restricted | 884 (92.2) | 128 (13.3) | <0.001 | 38 (9.7) | 90 (15.8) | 0.024 |
| Not restricted but rarely held | 70 (7.3) | 504 (52.6) | 212 (54.4) | 292 (51.3) | |||
| Not restricted | 5 (0.5) | 327 (34.1) | 140 (35.9) | 187 (32.9) | |||
| Private meals and gatherings with colleagues | Restricted | 770 (80.3) | 48 (5.0) | <0.001 | 10 (2.6) | 38 (6.7) | 0.010 |
| Not restricted but rarely held | 163 (17.0) | 404 (42.1) | 176 (45.1) | 228 (40.1) | |||
| Not restricted | 26 (2.7) | 507 (52.9) | 204 (52.3) | 303 (53.3) | |||
| Private meals and gatherings with people other than colleagues | Restricted | 682 (71.1) | 26 (2.7) | <0.001 | 4 (1.0) | 22 (3.9) | 0.024 |
| Not restricted but rarely held | 228 (23.8) | 263 (27.4) | 113 (29.0) | 150 (26.4) | |||
| Not restricted | 49 (5.1) | 670 (69.9) | 273 (70.0) | 397 (69.8) | |||
| Examinees | |||||||
| Wearing masks When undergoing check-ups | Compulsory | 940 (98.0) | 719 (75.0) | <0.001 | 221 (56.7) | 498 (87.5) | <0.001 |
| Recommended | 18 (1.9) | 215 (22.4) | 150 (38.5) | 65 (11.4) | |||
| Personal choice | 1 (0.1) | 25 (2.6) | 19 (4.9) | 6 (1.1) | |||
| Undergoing check-ups after having a fever | Not allowed for a certain time | 842 (87.8) | 482 (50.3) | <0.001 | 157 (40.3) | 325 (57.1) | <0.001 |
| Allowed if the COVID-19 test is negative | 99 (10.3) | 216 (22.5) | 98 (25.1) | 118 (20.7) | |||
| Allowed if the fever has broken | 18 (1.9) | 261 (27.2) | 135 (34.6) | 126 (22.1) | |||
| The number of days examinees are not allowed to undergo check-ups after a COVID-19 infection | No restrictions | N/A | N/A | N/A | 48 (12.3) | 45 (7.9) | <0.001 |
| 5 days | N/A | N/A | 216 (55.4) | 191 (33.6) | |||
| 7 days | N/A | N/A | 59 (15.1) | 140 (24.6) | |||
| ≥10 days | N/A | N/A | 64 (16.4) | 188 (33.0) | |||
| Others | N/A | N/A | 3 (0.8) | 5 (0.9) | |||
| Univariate model | Multivariate model | ||||
|---|---|---|---|---|---|
| Odds ratio (95% CI) | P value | Odds ratio (95% CI) | P value | ||
| (Intercept) | - | - | 0.05 (0.02-0.14) | <0.001 | |
| Type of facility | Not annexed to hospitals | Ref | Ref | ||
| Annexed to hospitals | 1.67 (1.25-2.24) | <0.001 | 1.69 (1.18-2.41) | 0.004 | |
| Area | Kanto | Ref | Ref | ||
| Hokkaido | 0.78 (0.27-2.22) | 0.641 | 0.56 (0.17-1.85) | 0.344 | |
| Tohoku | 1.18 (0.65-2.17) | 0.582 | 1.11 (0.59-2.12) | 0.743 | |
| Chubu | 0.69 (0.46-1.04) | 0.079 | 0.64 (0.41-0.99) | 0.047 | |
| Kansai | 0.97 (0.66-1.43) | 0.893 | 1.03 (0.68-1.56) | 0.874 | |
| Chugoku | 0.66 (0.37-1.20) | 0.172 | 0.60 (0.32-1.12) | 0.106 | |
| Shikoku | 0.20 (0.05-0.86) | 0.031 | 0.23 (0.05-1.02) | 0.053 | |
| Kyushu | 1.01 (0.60-1.70) | 0.960 | 1.00 (0.58-1.74) | 0.995 | |
| Okinawa | 4.37 (1.07-17.8) | 0.040 | 3.02 (0.65-13.98) | 0.157 | |
| Location of facilities | Locations outside ordinance-designated cities or special wards in Tokyo | Ref | Ref | ||
| Ordinance-designated cities or special wards in Tokyo | 1.01 (0.76-1.34) | 0.960 | 1.03 (0.74-1.42) | 0.864 | |
| Public or private institutions | Private | Ref | Ref | ||
| Public | 1.10 (0.77-1.56) | 0.604 | 0.93 (0.63-1.38) | 0.720 | |
| Number of employees | 1-10 | Ref | Ref | ||
| 11-20 | 1.27 (0.85-1.89) | 0.250 | 0.45 (0.24-0.86) | 0.015 | |
| 21-40 | 1.28 (0.86-1.89) | 0.227 | 0.81 (0.45-1.46) | 0.490 | |
| >40 | 1.01 (0.66-1.54) | 0.960 | 0.64 (0.32-1.30) | 0.216 | |
| Negative financial impact in 2023 | Yes | 2.08 (1.53-2.83) | <0.001 | 1.97 (1.42-2.75) | <0.001 |
| Employees complain that COVID-19-related rules are too strict | Yes | 2.89 (1.78-4.68) | <0.001 | 2.96 (1.77-4.96) | <0.001 |
| Some employees have difficulty working due to long COVID | Yes | 3.57 (2.20-5.79) | <0.001 | 3.39 (2.03-5.66) | <0.001 |
| Wearing masks indoors during personal time | Personal choice | Ref | Ref | ||
| Compulsory or recommended | 1.36 (1.00-1.84) | 0.048 | 1.23 (0.86-1.76) | 0.250 | |
| Taking COVID-19 tests for fever | Personal choice | Ref | Ref | ||
| Compulsory or recommended | 0.93 (0.64-1.36) | 0.709 | 0.83 (0.54-1.27) | 0.384 | |
| When family members are infected with COVID-19 | No restriction/allowed to work if they are not sick | Ref | Ref | ||
| Employees are not allowed to work for a certain period | 1.05 (0.75-1.47) | 0.772 | 1.01 (0.70-1.46) | 0.963 | |
| Employees are recommended to receive the COVID-19 vaccination | Yes | 1.03 (0.78-1.36) | 0.833 | 0.84 (0.61-1.14) | 0.255 |
| Organizational social gathering among employees involving meals | Not restricted | Ref | Ref | ||
| Restricted/Not restricted but rarely held | 1.19 (0.88-1.60) | 0.263 | 1.28 (0.87-1.90) | 0.215 | |
| Private meals with people other than colleagues | Not restricted | Ref | Ref | ||
| Restricted/Not restricted but rarely held | 1.04 (0.77-1.41) | 0.802 | 0.81 (0.56-1.17) | 0.267 | |
| Organizational social gathering among employees involving meals held in FY2019/FY2023 | FY2019: no FY2023: no | Ref | Ref | ||
| FY2019: no FY2023: yes | 0.83 (0.55-1.24) | 0.360 | 0.95 (0.61-1.51) | 0.841 | |
| FY2019: yes FY2023: no | 0.88 (0.60-1.29) | 0.505 | 0.89 (0.59-1.34) | 0.571 | |
| FY2019: yes FY2023: yes | 0.86 (0.58-1.28) | 0.457 | 0.92 (0.58-1.45) | 0.715 | |
| Total (n = 104) | Not annexed to hospitals (n = 20) | Annexed to hospitals (n = 84) | P value | ||
|---|---|---|---|---|---|
| Rate of increase in resignations compared to the pre-pandemic period (single answer) | <10% 10%-30% 30%-50% >50% |
47 (45.2) 46 (44.2) 3 (2.9) 2 (1.9) |
8 (40.0) 10 (50.0) 0 (0.0) 0 (0.0) |
39 (46.4) 36 (42.9) 3 (3.6) 2 (2.4) |
0.675 |
| Job types with increased resignations (multiple answers) | Doctors | 12 (11.5) | 3 (15.0) | 9 (10.7) | 0.881 |
| Nurses | 86 (82.7) | 12 (60.0) | 74 (88.1) | 0.008 | |
| Clinical laboratory technologists | 14 (13.5) | 6 (30.0) | 8 (9.5) | 0.041 | |
| Radiologic technologists | 6 (5.8) | 1 (5.0) | 5 (6.0) | >0.999 | |
| Pharmacists | 4 (3.8) | 0 (0.0) | 4 (4.8) | 0.728 | |
| Other medical professionals | 12 (11.5) | 3 (15.0) | 9 (10.7) | 0.881 | |
| Clerical workers | 41 (39.4) | 12 (60.0) | 29 (34.5) | 0.066 | |
| Reasons for increased resignation (multiple answers) | Increased workload due to patients with COVID-19 | 71 (68.3) | 7 (35.0) | 64 (76.2) | 0.001 |
| Shortage of communications | 37 (35.6) | 7 (35.0) | 30 (35.7) | >0.999 | |
| Stress due to restrictions in private life | 18 (17.3) | 1 (5.0) | 17 (20.2) | 0.197 | |
| New job with better conditions | 7 (6.7) | 3 (15.0) | 4 (4.8) | 0.252 | |
| Other reasons (below) | 16 (15.4) | 5 (25.0) | 11 (13.1) | 0.326 | |
| Other reasons (open-ended response) | Increased overall workload | 2 (1.9) | |||
| Deterioration of working conditions due to the worsening financial situation | 2 (1.9) | ||||
| A gap between the actual work and expectations due to the lack of pre-employment training | 2 (1.9) |
| Univariate model | Multivariate model | ||||
|---|---|---|---|---|---|
| Odds ratio (95% CI) | P value | Odds ratio (95% CI) | P value | ||
| (Intercept) | - | - | 0.05 (0.02-0.14) | <0.001 | |
| Type of facility | Not annexed to hospitals | Ref | Ref | ||
| Annexed to hospitals | 3.20 (1.93-5.31) | <0.001 | 2.83 (1.56-5.13) | <0.001 | |
| Area | Kanto | Ref | Ref | ||
| Hokkaido | 3.02 (1.03-8.89) | 0.045 | 2.85 (0.85-9.54) | 0.090 | |
| Tohoku | 1.06 (0.42-2.65) | 0.906 | 0.91 (0.34-2.43) | 0.852 | |
| Chubu | 1.12 (0.63-2.00) | 0.690 | 0.99 (0.53-1.86) | 0.977 | |
| Kansai | 0.84 (0.46-1.55) | 0.577 | 0.84 (0.44-1.62) | 0.611 | |
| Chugoku | 0.90 (0.38-2.11) | 0.803 | 0.92 (0.37-2.31) | 0.862 | |
| Shikoku | 0.37 (0.05-2.81) | 0.335 | 0.51 (0.06-4.12) | 0.529 | |
| Kyushu | 1.04 (0.48-2.27) | 0.916 | 0.95 (0.41-2.20) | 0.913 | |
| Okinawa | 4.23 (1.01-17.66) | 0.048 | 2.39 (0.42-13.44) | 0.324 | |
| Location of facilities | Locations outside ordinance-designated cities or special wards in Tokyo | Ref | Ref | ||
| Ordinance-designated cities or special wards in Tokyo vs others | 0.95 (0.63-1.45) | 0.815 | 1.25 (0.77-2.02) | 0.376 | |
| Public or private institutions | Private | Ref | Ref | ||
| Public | 1.58 (0.99-2.54) | 0.056 | 1.13 (0.66-1.92) | 0.660 | |
| Number of employees | 1-10 | Ref | Ref | ||
| 11-20 | 0.60 (0.33-1.09) | 0.095 | 0.45 (0.24-0.86) | 0.015 | |
| 21-40 | 1.01 (0.60-1.70) | 0.976 | 0.81 (0.45-1.46) | 0.490 | |
| >40 | 0.58 (0.31-1.08) | 0.086 | 0.64 (0.32-1.30) | 0.216 | |
| Negative financial impact in 2023 | Yes | 1.75 (1.13-2.69) | 0.012 | 1.35 (0.84-2.18) | 0.213 |
| Employees complain that COVID-19 related rules are too strict | Yes | 1.89 (1.00-3.58) | 0.0498 | 1.20 (0.59-2.45) | 0.615 |
| Some employees have difficulty in working due to long COVID | Yes | 1.31 (0.65-2.65) | 0.443 | 0.79 (0.35-1.75) | 0.558 |
| Wearing masks indoors in private time | Personal choice | Ref | Ref | ||
| Compulsory or recommended | 1.03 (0.67-1.59) | 0.896 | 0.76 (0.45-1.26) | 0.285 | |
| Taking COVID-19 tests for fever | Personal choice | Ref | Ref | ||
| Compulsory or recommended | 0.95 (0.55-1.65) | 0.859 | 0.87 (0.46-1.64) | 0.660 | |
| When family members are infected with COVID-19 | No restriction/allowed to work if they are not sick | Ref | Ref | ||
| Employees are not allowed to work for a certain period | 0.95 (0.58-1.57) | 0.846 | 0.83 (0.48-1.44) | 0.505 | |
| Employees are recommended to receive the COVID-19 vaccination | Yes | 1.54 (1.02-2.33) | 0.040 | 1.41 (0.88-2.24) | 0.150 |
| Organizational social gathering among employees involving meals | Not restricted | Ref | Ref | ||
| Restricted or rarely held | 1.31 (0.84-2.05) | 0.232 | 1.01 (0.55-1.85) | 0.972 | |
| Private meals with people other than colleagues | Not restricted | Ref | Ref | ||
| Restricted or rarely held | 0.98 (0.63-1.53) | 0.938 | 0.94 (0.55-1.60) | 0.814 | |
| Organizational social gathering among employees involving meals held in FY2019/FY2023 | FY2019: no FY2023: no | Ref | Ref | ||
| FY2019: no FY2023: yes | 0.38 (0.17-0.84) | 0.017 | 0.35 (0.15-0.83) | 0.017 | |
| FY2019: yes FY2023: no | 1.81 (1.05-3.12) | 0.032 | 1.79 (1.00-3.21) | 0.0503 | |
| FY2019: yes FY2023: yes | 1.24 (0.69-2.24) | 0.472 | 1.14 (0.58-2.25) | 0.703 | |
| Negative impact on the mental health of employees | Yes | 3.44 (2.27-5.21) | <0.001 | 3.26 (2.07-5.15) | <0.001 |
