The organization and financing of end-stage renal disease treatment in Japan.
End-stage renal disease (ESRD) affects 230,000 Japanese, with about 36,000 cases diagnosed each year. Recent increases in ESRD incidence are attributed mainly to increases in diabetes and a rapidly aging population. Renal transplantation is rare in Japan. In private dialysis clinics, the majority of treatment costs are paid as fixed fees per session and the rest are fee for service. Payments for hospital-based dialysis are either fee-for-service or diagnosis-related. Dialysis is widely available, but reimbursement rates have recently been reduced. Clinical outcomes of dialysis are better in Japan than in other countries, but this may change given recent ESRD cost containment policies.
Fukuhara
Shunichi
S
Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan. fukuhara@pbh.med.kyoto-u.ac.jp
Yamazaki
Chikao
C
Hayashino
Yasuaki
Y
Higashi
Takahiro
T
Eichleay
Margaret A
MA
Akiba
Takashi
T
Akizawa
Tadao
T
Saito
Akira
A
Port
Friedrich K
FK
Kurokawa
Kiyoshi
K
D003956:Dialysis / Q000191:economics; D005102:Health Expenditures; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000628:therapy*; D016030:Kidney Transplantation / Q000191:economics; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*; D015995:Prevalence
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