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OECD Reviews of Health Care Quality: Japan 2015

Raising Standards

image of OECD Reviews of Health Care Quality: Japan 2015

This report reviews the quality of health care in Japan, and seeks to highlight best practices, and provides a series of targeted assessments and recommendations for further improvements to quality of care. One of Japan’s foremost policy challenges is to create an economically-active ageing society. Excellent health care will be central to achieving this. A striking feature of the Japanese health system is its openness and flexibility. In general, clinics and hospitals can provide whatever services they consider appropriate, clinicians can credential themselves in any speciality and patients can access any clinician without referral. These arrangements have the advantage of accessibility and responsiveness. Such light-touch governance and abundant flexibility, however, may not best meet the health care needs of a super-ageing society. Japan needs to shift to a more structured health system, separating out more clearly different health care functions (primary care, acute care and long-term care, for example) to ensure that peoples’ needs can be met by the most appropriate service, in a coordinated manner if needed. As this differentiation occurs, the infrastructure to monitor and improve the quality of care must simultaneously deepen and become embedded at every level of governance –institutionally, regionally and nationally.

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Improving the quality of Japan's hospital care

With a large number of hospital beds, long lengths of stay and low discharge rates, the hospital setting has traditionally been the dominant sector in the Japanese health care system. Given that patients are able to access hospitals specialists directly for any health care need, consumer preferences for seeking hospital care had been traditionally high. However, as demonstrated by some acute care quality indicators, such as 30-day mortality after acute myocardial infarction, there is room for improvement in the quality of hospital care in Japan. Ongoing reforms in the hospital sector seek to differentiate acute from non-acute beds to ensure an appropriate use of hospital resources and improve both outcome and efficiency of care. This chapter seeks to contribute to the implementation process of these reforms by suggesting key instruments to steer quality improvement in the hospital sector as a whole.

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