Cost containment and quality of care in Japan: is there a trade-off?

  title={Cost containment and quality of care in Japan: is there a trade-off?},
  author={Hideki Hashimoto and Naoki Ikegami and Kenji Shibuya and Nobuyuki Izumida and Haruko Noguchi and Hideo Yasunaga and Hiroaki Miyata and Jose M. Acuin and Michael R. Reich},
  journal={The Lancet},

An Effective Approach To Containing Costs In Japan , All-Payer Rate Setting Under Tight Government Control Has Proved To Be

Japan’s approach confirms that enlightened government regulation can maintain access to care, avoid rationing, make use of the latest technology, and allow for multiple insurance plans and an aging population—all while restraining the growth of health care spending.

In Japan, all-payer rate setting under tight government control has proved to be an effective approach to containing costs.

Japan's approach confirms that enlightened government regulation can maintain access to care, avoid rationing, make use of the latest technology, and allow for multiple insurance plans and an aging population--all while restraining the growth of health care spending.

Current Trends in Health Insurance Systems: OECD Countries vs. Japan

In spite of some urgently decided measures to cover the high cost of advanced medical treatment, declining birthrate and aging population and the tendency to reduce hospital and outpatients’ visits numbers and shorten hospital stays, medical expenses of Japan continue to be increasing.

The roles of public and private insurance for the health-care reform of Japan

The purpose of this paper is to identify the main features of Japanese health-care system and to present a direction for reform, and it finds that many apparently different problems in Japan have stemmed from the government's significant subsidies to insurers.

The best of both worlds? The economic effects of a hybrid fee-for-service and prospective payment reimbursement system.

The results suggest that in some cases, a hybrid payment system can be non-superior to either FFS or prospective payment system.

Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries

  • N. Ikegami
  • Medicine, Political Science
    International journal of health policy and management
  • 2016
The policy decisions which have helped to retain primary care services in Japan might provide lessons for achieving universal health coverage in low- and middle-income countries (LMICs).

Comparison of New Drug Accessibility and Price Between Japan and Major European Countries

From the viewpoint of the health insurance coverage proportion and the speed of reimbursement decision, the hurdle to access new drugs in Japan is lower than that in major European countries.

Health Policy in Japan – Current Situation and Future Challenges

  • S. Matsuda
  • Medicine, Political Science
    JMA journal
  • 2019
It is believed that strengthening the foundations of health service research is crucially important for public health administration in Japan and the existence of appropriate information regarding health needs is crucial for reliable administration.



Japan's health care system: containing costs and attempting reform.

As Japan's economy declined, more intensive control of prices and even volume through the fee schedule, plus increases in various copayment rates, led to an actual reduction of medical spending in

Health care reform in Japan: the virtues of muddling through.

Japan's universal and egalitarian health care system helps to keep its population healthy at an exceptionally low cost. Its financing and delivery systems have been adapted over the years in a

Games policy makers and providers play: introducing case-mix-based payment to hospital chronic care units in Japan.

  • N. Ikegami
  • Medicine, Political Science
    Journal of health politics, policy and law
  • 2009
In order to monitor compliance and to evaluate whether the patient is being billed for the appropriate case-mix group, the government must invest in developing a comprehensive patient-level database and in training staff for making on-site inspections.

What has made the population of Japan healthy?

Crossing the Quality Chasm: A New Health System for the 21st Century

  • A. Baker
  • Medicine, Political Science
    BMJ : British Medical Journal
  • 2001
Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

The Japanese national health screening and intervention program aimed at preventing worsening of the metabolic syndrome.

The Japanese Ministry of Health, Labor and Welfare has decided to introduce a nationwide health screening and intervention program specifically targeting the metabolic syndrome commencing April 2008, and the underlying objective and details of the new screening program are discussed.

Applying RUG-III in Japanese long-term care facilities.

There was wide discrepancy between the stated purpose of Japanese facilities and their patient populations, and the current payment mechanism did not reflect actual use of resources.

The relationship between consultation length, process and outcomes in general practice: a systematic review.

  • Andrew WilsonS. Childs
  • Medicine, Political Science
    The British journal of general practice : the journal of the Royal College of General Practitioners
  • 2002
There were consistent differences in several elements of process and outcome between general practitioners who consult at different rates and the evidence suggests that patients seeking help from a doctor who spends more time with them are more likely to have a consultation that includes important elements of care.