OECD Reviews of Health Care Quality: Japan 2015

Raising Standards

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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.


Quality of health care in Japan

This chapter summarises the main policies and activities that are in place in Japan to assure and improve quality of health care. After describing the legal framework around quality of care in Japan, regional medical care plans to improve health system performance at the prefecture level, and the national fee schedule which is used to control health spending growth and also to stir changes in medical practice patterns and quality improvement, this chapter focuses on other quality governance structure such as mechanisms to assure quality of professionals, facilities, and pharmaceuticals. The chapter continues with clinical guideline development, information infrastructure for quality monitoring and reporting, and systems to promote patient safety. Specific attention is given, lastly, to policies aimed at strengthening the role and perspective of the patient in the health system.


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