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 2002 for the first time in history. To augment established mechanisms of cost containment, case-mix-based inclusive fees for inpatient care were introduced in university hospitals in 2003 and are planned for subacute and long-term care. However, substantial reform, including the introduction of market-based medicine, is not likely to occur in other areas. Progress in making the delivery system more accountable to patients has been meaningful but slow.
Ikegami
Naoki
N
Department of Health Policy and Administration, Keio University School of Medicine, Tokyo. ikegami@sc.itc.keio.ac.jp
Campbell
John Creighton
JC
D003363:Cost Control; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D018166:Health Care Reform / Q000379:methods*; D005102:Health Expenditures / Q000639:trends; D006801:Humans; D007564:Japan