Japan-hospitals : the journal of the Japan Hospital Association最新文献

Aim and method: To improve employment support measures for patients with cancer, the author collected study reports and material published from January 2010 through January 2016 and analyzed cancer epidemiology, treatment costs, cancer's negative impact on patients, resignation rates, factors affecting employment, and the state of support in Japan.

Results: Approximately 30% of workers suffering from cancer (regular employees: 21%; non-regular employees: 39%) resigned from work. Over 80% of patients with cancer wished to remain employed (nearly 70% among patients who had resigned following incidence of cancer) in order to maintain their households and quality of life and cover cancer treatment costs. Approximately half of the Japanese companies surveyed did not grasp the employees' cancer incidence, considering it to be a private injury. Additionally, 74% of companies had not recorded one month or more of absences due to cancer- related sickness. Nonetheless, among large companies, around 70% of regular employees with cancer were able to return to work (RTW) within one year of the start of cancer-related sickness absence (81% returned working shorter hours; 62% returned to full-time work).

Conclusions: A year of sickness absence and shorter working hours enables employees with cancer to RTW. Employment continuation support should principally promote RTW from the initial announcement of cancer. The author proposes a modified health promotion management strategy that aims to ensure a safe RTW through employers' systematic initiatives and with employees' collaborative effort to improve wellness in the corporate community. Collaboration between hospitals, companies' industrial medical staff, and company staff will facilitate RTW. Policy aimed at reducing hospital stays requires that ambulatory nurses in hospitals plan long-term individual nursing care and provide high-quality nursing care tailored to the various needs of patients, according to the Information Prescription. However, this service's medical fee valuation is low. Improving ambulatory nursing therefore requires increasing this fee.

The ageing society issue has necessitated the Japanese government conducting health reform. In order to reorganize the health service delivery system, the Ministry of Health, Labour and Welfare (MHLW) has prepared two massive health related data bases; DPC (Diagnosis Procedure Combination) data and NDB (National Receipt Database). The former gathers about 11 million discharged cases from 1,900 acute care hospitals annually. The latter gathers more than 1.7 billion claim data from all medical facilities every year. Using these data bases, we can evaluate the current system and estimate the future health needs of each region. As the backbone of the Japanese health system is a publicly funded private dominant supply system, the existence of useful information concerning health needs is crucial for sound management, especially for the private sector. In this article, the author reveals some examples of the application of these two massive databases for regional health planning and hospital management.

DPC (Diagnosis Procedure Combination) is the Japanese original Case Mix system. The principal purpose of DPC introduction is not only for payment arrangement but also for modernization of the health system. To improve the quality of hospital management, to strengthen the responsibility of hospital for accountability, and to rationalize the health system are the three main objectives of the project. Based on the current DPC database, patients can know the clinical performance of each acute care hospital, such as volume stratified by diseases and disorders and related quality indicators. Furthermore, DPC data is used for regional health care planning. In this article, the author provides an overview of the DPC system with some examples.

The "Social Healthcare Corporation" system was established on 1 April 2007 as a result of the revised Japanese Medical Care Law. As of 1 October 2014, 234 corporations are certified Social Healthcare Corporations. These corporations are allowed to issue public bonds. However, to this day (1 December 2014), no bonds have been issued. In this paper, we focus on cost analysis with respect to issuing public bonds.