SECTION OF HOSPITAL MEDICINE The Health Care System of Japan Gregory Ruhnke, MD, MS, MPH Section of...
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Transcript of SECTION OF HOSPITAL MEDICINE The Health Care System of Japan Gregory Ruhnke, MD, MS, MPH Section of...
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SECTION OF HOSPITAL MEDICINE
The Health CareSystem of Japan
Gregory Ruhnke, MD, MS, MPH
Section of Hospital MedicineUniversity of Chicago
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Lancet. 2011 Sep 24;378(9797):1174-82
Cost containment and quality of care in Japan: is there a trade-off?
Hashimoto H1, Ikegami N, Shibuya K, Izumida N, Noguchi H, Yasunaga H, Miyata H, Acuin JM, Reich MR.
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• Excellent health status• >= age 65 from 9% in 1980 to 23% in 2010• Nationally uniform fee schedule• 3500 insurers (majority private)• Fee schedule adjusted based on volumes• Prices for services are low• Frequent outpatient physician visits• Reliance on the family
Key Components
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SECTION OF HOSPITAL MEDICINE
# surgical procedures requiring general anesthesia per 1000 population
Japan 18USA 39
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SECTION OF HOSPITAL MEDICINE
# MDs and nurses per hospital bed
MDs NursesJapan 27 117OECD 100 249
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SECTION OF HOSPITAL MEDICINE
Specialization of physicians:
Physicians can proclaim any subspecialty at their discretion.
General practice has not been recognized as a specialty.
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Quality of Care
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SECTION OF HOSPITAL MEDICINE
Low post-surgical mortality rates
Consolidation of services to maximize volume
81% of surgical procedures at hospitals with >200 beds, which comprise only 17.5% of hospitals
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SECTION OF HOSPITAL MEDICINE
39% among time-limited cert MDs
23% among time-unlimited cert MDs
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SECTION OF HOSPITAL MEDICINE
Thank You