[Medical economics in tuberculosis management: what will come after the TB ward?].
Current unprofitability of medical services in tuberculosis (TB) ward in Japan has been induced by low medical fee and long-term hospital stays, aggravated by unoccupied beds due to the decrease in the number of patients. For the solution of this issue, the increase of medical fee, shortening of the length of hospital stay and drastic reduction of oversupplied beds are essential. An increment of medical fee by the change in the system would be appreciated, but even under the current system, the balance between revenue and expenditure could be obtained by reducing the length of hospital stay toward 4 weeks, and the elimination of deficit in TB ward could be accomplished by these efforts; shortening of length of hospital stay and reduction of TB beds. Although the latter might result in the difficulty of sustaining TB wards, these patients could be treated in the infectious disease ward. The integration of TB Control Law to Infectious Disease Control Law suggests that TB is not a special disease in Japan. If a true "short course therapy" era would be realized by novel anti-tuberculosis drugs, a dramatic change in TB management would occur in the near future.
Yotsumoto
Hideki
H
NHO Tokyo National Hospital, 3-1-1, Takeoka, Kiyose-shi, Tokyo 204-8585, Japan. yotsumoto@tokyo-hosp.jp
D000995:Antitubercular Agents; D003140:Communicable Disease Control / Q000331:legislation & jurisprudence; D055808:Drug Discovery; D004470:Economics, Medical / Q000639:trends*; D005251:Fees, Medical / Q000706:statistics & numerical data*; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay; D010351:Patient Discharge / Q000592:standards; D010362:Patients' Rooms / Q000191:economics* / Q000706:statistics & numerical data / Q000639:trends; D014376:Tuberculosis / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control
D000995:Antitubercular Agents