title: Cost containment: the Pacific. Japan.
abstract: The Japanese healthcare system is structured to provide universal healthcare access to the entire Japanese population via a constitutional guarantee. Increasing costs within the Japanese healthcare system are largely attributable to the country's rapidly aging population. Intensive care services are provided primarily in large tertiary care hospitals by a relatively small cadre of dedicated critical care physicians. Triage pressure is high in many Japanese hospitals due to a relatively small proportion of ICU beds. As a result, few patients are admitted to the ICU at low risk of adverse outcome or monitoring. Costs associated with providing critical care are poorly understood because of current hospital cost accounting systems. Critical care costs have only recently become an area of concern. Nevertheless, critical care physicians are taking steps to more fully understand severity of illness, clinical outcome, and utilization of resources in order to effectively guide healthcare policy and resource allocation decisions impacting Japanese critical care.
authors.affiliation: Trauma and Critical Care Center, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tajimi
authors.forename: Y
authors.initials: Y
authors.lastname: Shimada
authors.forename: S
authors.initials: S
authors.lastname: Nishimura
authors.forename: C A
authors.initials: CA
authors.lastname: Sirio
mesh_terms: D000066:Accounting; D000367:Age Factors; D000368:Aged; D003363:Cost Control / Q000379:methods*; D003422:Critical Care / Q000191:economics* / Q000706:statistics & numerical data; D003659:Decision Making, Organizational; D003695:Delivery of Health Care / Q000191:economics*; D006751:Hospital Information Systems; D006801:Humans; D007564:Japan; D017063:Outcome Assessment, Health Care / Q000458:organization & administration; D010564:Personnel, Hospital / Q000191:economics / Q000600:supply & distribution; D012720:Severity of Illness Index; D014218:Triage / Q000458:organization & administration