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2 Hospital beds per 1000 population in selected countries in 2015 

2 Hospital beds per 1000 population in selected countries in 2015 

Citations

... This result is influenced by the number of medical facilities per population in each area, in other words, the accessibility of medical services. In addition, in Japan's medical insurance system which all people belong to, the insured can choose their own medical institutions (Sakamoto et al. 2018). Such high accessibility are likely to have an impact on the results of the study. ...
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The built environment is a structural determinant of health. Here we reveal spatially heterogeneous associations of built environment indicators with objective health outcomes (morbidity) by combining a random forest (RF) approach and a multiscale geographically weighted (MGWR) regression method. Using data from six Japanese cities, we found that the ratio of morbidity has obvious spatial agglomerations. The mixed land-use diversity with 1000 m buffer, distance to hospital, proportion of park area with 300 m buffer, and house price with 2000 m buffer, negatively affect health outcomes at all locations. For most locations, high PM2.5 or high floor area ratio with 2000 m buffer are linked to a high ratio of morbidity. Our findings support the use of such data for long-term urban and health planning. We expect our study to be a starting point for further research on spatially heterogeneous associations of the built environment with comprehensive health outcomes.
... In addition, higher levels of pain catastrophizing may be reflected by the difference in frequency of healthcare delivery between countries. On a per-population basis, Asian countries, particularly Japan, tend to have a high number of medical practitioner consultations, hospital beds, lengths of stay in hospital, magnetic resonance imaging units, and computed tomography (CT) scanners than European countries [24]; for example, the number of CT scanners per population in Japan is approximately double the number in Australia [25]. Frequent testing and visits to doctors have been found to provide little reassurance and increase feelings of worry and anxiety among patients [26]. ...
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Introduction: This systematic review aimed to investigate variations of reference scores for the Pain Catastrophizing Scale (PCS) between language versions and between countries in patients with chronic primary pain (CPP) or chronic primary pain, not otherwise specified (CPP-NOS). Methods: Electronic searches of the Ovid/Embase, Ovid/MEDLINE, and Ovid/PsycINFO databases were conducted to retrieve studies assessing PCS scores in adults with CPP or CPP-NOS proposed by the International Classification of Diseases, Eleventh Revision for any country where the translated PCS was available. The protocol for this systematic review was prospectively registered on the International Prospective Register of Systematic Reviews 2018 (registration number: CRD 42018086719). Results: A total of 3634 articles were screened after removal of duplicates. From these, 241 articles reporting on 32,282 patients with chronic pain were included in the review. The mean (± standard deviation) weighted PCS score across all articles was 25.04 ± 12.87. Of the 12 language versions and 21 countries included in the review, the weighted mean PCS score in Asian languages or Asian countries was significantly higher than that in English, European, and other languages or Western and other countries. The highest mean score of the weighted PCS based on language was in Japanese (mean 33.55), and the lowest was in Russian (mean 20.32). The highest mean score of the weighted PCS based on country was from Japan (mean 33.55), and the lowest was from Australia (mean 19.80). Conclusion: The weighted PCS scores for people with CPP or CPP-NOS were significantly higher in Asian language versions/Asian countries than in English, European and other language versions or Western and other countries.
... Because the role of general practitioner/family physicians is ambiguous in Japan [24], patients or residents might find it difficult to answer questions such as "How would you assess your primary care experience?" or, "My practice makes it easy for me to get care. " Therefore, we targeted participants who had the "usual source of care (USC)" as the respondents of the questionnaire. ...
... Third, terms and phrases about PC in PCPCM are difficult for Japanese participants to understand. In Japan, because there is no gate-keeping system by a PC physician and a patient can access secondary care directly [24,34], respondents might not understand some phrases in the PCPCM, such as: "your primary care experience" in "How would you assess your primary care experience?" and "my practice" in "My practice makes it easy for me to get care. " To overcome these limitations, we, a team of Japanese family physicians, developed the alternative Japanese version of the PCPCM, focusing on participants who have USC. ...
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Background Although primary care (PC) is an indispensable part of the health system, measuring its quality is challenging. A recent measure of PC, Person-Centered Primary Care Measure (PCPCM), covers 11 important domains of PC and has been translated into 28 languages. This study aimed to develop a Japanese version of the PCPCM and assess its reliability and validity. Methods We employed a cross-sectional mail survey to examine the reliability and content, structure, criterion-related, and convergent validity of the Japanese version of the PCPCM. This study targeted 1000 potential participants aged 20–74 years, selected by simple random sampling in an urban area in Japan. We examined internal consistency, confirmatory factor analysis, correlation between the Japanese version of the Primary Care Assessment Tool-Short Form (JPCAT-SF), and the association between the PCPCM score and influenza vaccine uptake. Results A total of 417 individuals responded to the survey (response rate = 41.7%), and we used the data of 244 participants who had the usual source of care to assess the reliability and validity of the PCPCM. Confirmatory factor analysis demonstrated sufficient structural validity of the original one-factor structure. The overall Cronbach’s alpha was 0.94. The Spearman correlation coefficient between PCPCM and JPCAT-SF was 0.60. Influenza vaccine uptake was not significantly associated with total PCPCM score. Conclusions The study showed that the Japanese version of the PCPCM has sufficient internal consistency reliability and structural- and criterion-related validity. The measure can be used to compare the quality of primary care in Japan and other countries.
... Japan's public assistance programme, seikatsu-hogo, is a governmental welfare programme for people who live below the poverty line and do not possess any assets; approximately 1.7% of the population is enrolled in this programme. 23 Municipality governments provide recipients with monthly minimum income protection and medical care vouchers (iryo-ken), and they are fully exempted from copayments for the use of healthcare services covered by Japan's National Health Insurance programme. 23 The use of medical care vouchers has no restrictions. ...
... 23 Municipality governments provide recipients with monthly minimum income protection and medical care vouchers (iryo-ken), and they are fully exempted from copayments for the use of healthcare services covered by Japan's National Health Insurance programme. 23 The use of medical care vouchers has no restrictions. The size of the monthly subsidy depends on members' demographic characteristics and the socioeconomic conditions of their residential areas (eg, urbanicity, labour market conditions and standard living costs). ...
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Backgrounds Income reduction in poor households affects healthcare demands for impoverished population. However, the impact of reduced benefits for public assistance recipients, who can use medical services for free, on healthcare costs has not been examined. We hypothesised that marginal cuts in benefits increase recipients’ medical expenditure by extra demand for medical care. We tested this hypothesis using public assistance databases of Japan. Methods The study population comprised households in five municipalities receiving public assistance between April 2016 and September 2018. The households have a child aged 12–60 months and receive a monthly child-support income of US$150, which reduces by US$50 when the child turns 36 months of age. Our analysis comprised an age-based sharp regression-discontinuity study. Results We observed 4893 household-months (11 032 person-months). When a firstborn child reached 36 months, their frequency of outpatient visits and healthcare costs by recipients, except for the firstborn child, increased (0.45, 95% CI: 0.30 to 0.61; US$111.2, 95% CI: 20.7 to 201.7), while those of the firstborn child did not increase significantly. The monthly medical expenditure per household increased by US$248.6 (95% CI: 25.4 to 471.7). Inpatient medical costs increased significantly (US$64.3, 95% CI: 8.4 to 120.2). Conclusions Government savings through income reduction were offset by increased medical expenditure. This may be due to recipients’ behavioural change and their worsening health conditions. To prevent excessive medical expenditure, policymakers should consider how income reduction affects the behaviour and health of the impoverished population.
... Governance capacity: While Japan initially faced a shortage of low dead space syringes, its healthcare system is largely lauded and has contributed to the world's highest healthy life expectancy and eradication of common infectious diseases (Sakamoto et al., 2018). Even with high governance capacity, its stringent approval process for vaccines which delayed the rollout could be understood in the context of hesitancy from previous national vaccine programmes. ...
Article
How successful have countries in Asia been at vaccinating their populations against COVID-19? What explains the broadly similar pace of rollout across countries in the region despite diverse governance capacities, demographic compositions, resources and economies? This paper presents a comparative analysis of the planning and implementation of national vaccination drives against COVID-19 across 21 South and East Asian countries. We advance an analytical framework to understand the different challenges countries encounter and distinguish three key factors on both the national and international level—vaccine shortages, governance capacity for mass vaccination and vaccine hesitancy. We apply the analytical framework to national vaccination drives, offering a snapshot of countries’ vaccination progress as of early 2021, and conclude with general trends for the COVID-19 vaccine rollout across the region.
... 18 Specifically, we estimate a set of specifications based on an equation of the form 17 We are grateful to a referee for suggesting the inclusion of occupation to help control for socioeconomic behavioural differences related to health insurance. Japanese healthcare is characterized by a framework of universal health insurance coverage (see Sakamoto et al., 2018). For those out of the labour market plus the self-employed, this takes the form of National Health Insurance (NHI), a government health insurance scheme. ...
Article
We explore the effects of health and healthcare utilization on household saving and financial portfolios using data from the Japanese Household Panel Survey and the Keio Household Panel Survey. Poor psychological well-being is found to be associated with lower levels of savings and smaller financial portfolios, whereas associations with poor physical health are largely absent. Significantly, our findings do not support the hypothesis that poorer physical health is associated with savings accumulation. In contrast, healthcare utilization in the form of hospital visits, hospitalization, and health screening is associated with greater savings and larger financial portfolios. This suggests that healthcare based incentives to accumulate savings and financial wealth are related to channels associated with investment in health.
... Japan also has free access, does not have a patient list system or registration system. Hence, patients can choose any medical facilities, irrespective of disease severity or insurance status [9]. For the Japanese primary care system, primary care has been provided by various specialists [10]. ...
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Background This study aimed to explore associations between various elements of primary care, patient satisfaction, and loyalty. Methods This cross-sectional study used a modified version of the Primary Care Assessment Tool (PCAT), which was adapted for Japan. We distributed the PCAT questionnaire to patients aged 20 years or older at five rural primary care centres in Japan. We confirmed the validity and reliability of the measure for our study. Next, we examined which elements of primary care were related to patient satisfaction and loyalty using Spearman’s correlation and structural equation modelling. Results Of 220 eligible patients, 206 participated in this study. We developed nine component scales: first contact (regular access) , first contact (urgent access) , longitudinality , coordination , comprehensiveness (variety of care) , comprehensiveness (risk prevention) , comprehensiveness (health promotion) , family-centeredness , and community orientation . Longitudinality and first contact (urgent access) were related with patient satisfaction. Longitudinality , first contact (regular access) , and family-centeredness were related to patient loyalty. In the structural equation modelling analysis, two variables were significantly related to loyalty, namely a combined variable including longitudinality and first contact (regular access) , along with family-centeredness . Conclusions While a patient satisfaction model could not be distilled from the data, longitudinality , first contact (urgent access) , and family-centeredness were identified as important elements for the cultivation of patient loyalty. This implies that primary care providers need to develop a deep understanding of patients’ contexts and concerns and pay attention to their level of access to cultivate greater patient loyalty.
... Particularly, in the distribution of severely ill patients in Model 2, there are only 10 and 12 ICU beds in each of the two advanced acute This is a major challenge to staffing and equipment allocation and thus strongly suggests the requirement of preventive measures to curb the incidence of severely ill patients. In 2015, the number of hospitalized beds in Japan was 13.2 per 1,000 people compared with 4.9 in an average of other Organization for Economic Co-operation and Development (OECD) countries (29) . This study revealed that the hospital beds available during the COVID-19 pandemic in Yamanashi are able to avoid saturation through regional coordination, despite the high occupancy rate. ...
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Introduction: Whether healthcare providers can secure the number of beds that may be required during the coronavirus disease 2019 (COVID-19) pandemic remains unclear. This study aimed to determine the sufficiency of the hospital beds available to the healthcare system of Yamanashi, Japan, in accommodating hospitalized and severely ill patients during the COVID-19 pandemic. Methods: In total, 60 hospitals, with > 20 beds each, were included in this study (n = 10,684). However, beds in the psychiatric and tuberculosis wards (n = 2,295), nonoperational beds (n = 376), and beds for patients in the recovery and chronic phases (n = 3,494) were excluded. The projected occupancy rate was calculated based on the estimated number of patients, including severely ill patients requiring hospitalization during the COVID-19 pandemic. Based on the number of hospitalized patients, we created an adjusted model to calculate the mean occupancy rate of beds for each medical area in the prefecture (Model 1), which is free of areal occupancy rate biases. Moreover, we created an adjusted model that places severely ill patients in the two advanced acute hospitals in Yamanashi, thereby calculating the bed occupancy rates in other hospitals with > 200 beds (Model 2). Results: A total of 4,519 beds were analyzed. Although the existing infectious disease beds may not be able to accommodate the projected number of severely ill patients, the existing capacity can accommodate all patients projected to require hospitalization during the pandemic. In Model 1, the mean bed occupancy rate was 50%. Conversely, in Model 2, advanced acute hospital beds were insufficient for the projected number of severely ill patients, and the mean bed occupancy rate was 72.5%. Conclusions: Adjustment of patients across the medical area borders enables the existing hospital beds to accommodate the estimated number of patients requiring hospitalization or those who are severely ill.
... Thus, in this study, we selected Japan as a case because it has maintained a high level of equality and financial affordability in healthcare while experiencing widening socioeconomic disparity caused by demographic and economic challenges from 2000 to 2010 (Sakamoto et al., 2018). Therefore, focusing on Japan in the present study enabled us to examine a case in which social policies-rather than healthcare system performance-would affect changes in the socioeconomic gap in mortality. ...
... To address health conditions related to lifestyle behaviors, the Japanese Ministry of Health, Welfare and Labour adopted Healthy People Japan 2000, which mainly relied on a high-risk approach, conducting health screenings and individual-based behavioral modification for high-risk targets. This policy was reinforced by the introduction of the health-checkup-for-all policy in 2008, which specifically targeted obesity-related metabolic syndrome as a risk factor for diabetes and related complications (Sakamoto et al., 2018). A policy review in 2010, however, concluded that the targeted goals in population health and behavioral modification had not been achieved and called for a policy change to the population-based approach (OECD, 2019). ...
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Persistent socioeconomic disparity in mortality is a widely observed phenomenon despite improvements in the economic standard of living and the prevailing universal healthcare coverage policy. In this study, we selected Japan as a case in which public universal coverage has maintained horizontal equity in healthcare access while demographic and economic challenges have affected the life chances of vulnerable subpopulations over the past decade. We assessed the changing trends in the education-related disparity in mortality over a decade across demographic subpopulations for different causes of death, with the goal of generating social policy lessons to contribute to closing the mortality gap. Using a deterministic data merge between nationwide census and death records, we estimated age- and sex-specific mortality rates for 14 causes and their education-related gradients with absolute and relative indices of inequality in 2000 and 2010 via Poisson regression. Estimation parameters were standardized to the age structure of the sub-population of high school graduates in 2000 as the reference. The results demonstrated that the relative gaps in all-cause mortality persisted despite a decrease in the average mortality rate over the study period. The absolute gaps in mortality increased for preventable causes of death associated with lifestyle behavior choices. The average mortality worsened among socioeconomically vulnerable populations such as youth and women, who were left behind in the existing social/economic policy. External causes of death such as suicide and traffic accidents showed decreasing absolute gaps in a subpopulation targeted by universal social and labor policy measures. These change patterns indicate that, compared with a high-risk approach, a universal policy approach to dealing with societal and fundamental causes of health inequality seems more effective in reducing the education-related mortality gap in both absolute and relative terms.
... IQWiG also presented economic evaluations for the decision making of reimbursements using budget impact analysis for all cancer and 50% of the hepatitis C dossiers. On the other hand, HAS and C2H utilized cost effectiveness using ICER with QALY for price adjustments rather than for reimbursement decision making [28,29]. Note that Japan only formally introduced HTA and, more specifically, cost-effectiveness analysis in April 2019, after initiating a pilot programme that started in April 2016 [30]. ...
... In fact, in Japan, cost-effectiveness analysis of any intervention is only conducted if it has met all the criteria of clinical evidence. This might also be the reason for the absence of any clinical uncertainties by C2H since their main objective is to assess cost-effectiveness analyses [28]. ...
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Background Health technology assessment (HTA) organizations play a crucial role in optimizing healthcare resources, but the factors influencing decision making vary by country.ObjectiveHTAs of cancer and hepatitis C drugs were evaluated across developed countries to understand differences in decision processes and criteria.Methods The HTA organizations evaluated are from France, Germany, Italy, Spain, the United Kingdom (UK), Australia, Canada and Japan. Economic evaluation types and 28 factors in the following categories were evaluated: clinical uncertainties/issues; disease/population/treatment consideration factors including National Institute for Health and Care Excellence’s (NICE) special circumstances factors (e.g. end-of-life and innovation); and International Society for Pharmacoeconomics and Outcomes Research (ISPOR) additional value elements. Qualitative and correspondence analyses were conducted to assess the differences across organizations.ResultsIncremental cost-effectiveness ratio (ICER) using quality-adjusted life-year (QALY) was evaluated in Canada, the UK, Australia and Japan. The highest observed clinical uncertainties were clinical benefits and comparator. For cancer drugs, correspondence analysis showed France, Australia, Canada and the UK to have common attributes observed, such as unmet needs and stakeholder persuasion. In addition, the UK reported end-of-life, issues around current treatment and innovation, whereas Germany reported manageable/insignificant adverse events more frequently. Finally, fear of contagion, equity and scientific spillover value elements were only observed in Australia.Conclusion Although clinical factors play a predominant role in the decision to reimburse medicine, HTA organizations consider additional aspects as well. If the methodology of HTA was clearly outlined, there would be more transparency in HTA systems leading to better understanding amongst stakeholders about decision making.