A newly introduced comprehensive consultation fee in the national health insurance system in Japan: a promotive effect of multidisciplinary medical care in the field of radiation oncology--results from a questionnaire survey.
OBJECTIVE
The consultation fee for outpatient radiotherapy was newly introduced in the national health insurance system in Japan in April 2012. We conducted a survey on the use of this consultation fee and its effect on clinical practices.


METHODS
The health insurance committee of the Japanese Society of Therapeutic Radiology and Oncology conducted a questionnaire survey. The questionnaire form was mailed to 160 councilors of the Society, the target questionees. A total of 94 answers (58% of the target questionees) sent back were used for analyses.


RESULTS
The analyses revealed that 75% of the hospitals charged most of the patients who receive radiotherapy in an outpatient setting a consultation fee. The introduction of the consultation fee led to some changes in radiation oncology clinics, as evidenced by the response of 'more careful observations by medical staff' in 37% of questionees and a 12% increase in the number of full-time radiation oncology nurses. It was also shown that the vast majority (92%) of radiation oncologists expected a positive influence of the consultation fee on radiation oncology clinics in Japan.


CONCLUSIONS
Our questionnaire survey revealed the present status of the use of a newly introduced consultation fee for outpatient radiotherapy, and the results suggested its possible effect on promoting a multidisciplinary medical care system in radiation oncology departments in Japan.
*Department of Radiology, The University of Tokyo, 7-3-1, Hongo, Bunyo-ku, Tokyo 113-8655, Japan. igaki-tky@umin.ac.jp.
Hiroshi
H
Igaki
Hiroshi
H
Onishi
Keiichi
K
Nakagawa
Takushi
T
Dokiya
Kenji
K
Nemoto
Naoyuki
N
Shigematsu
Yasumasa
Y
Nishimura
Masahiro
M
Hiraoka
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D018588:Fee-for-Service Plans / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards / Q000639:trends; D005260:Female; D019538:Health Care Surveys; D006293:Health Promotion; D006280:Health Workforce; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D033183:Interdisciplinary Communication; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics* / Q000532:radiotherapy*; D010820:Physicians / Q000191:economics / Q000600:supply & distribution*; D018787:Radiation Oncology / Q000191:economics*; D011878:Radiotherapy / Q000191:economics; D012017:Referral and Consultation / Q000191:economics*; D011795:Surveys and Questionnaires
consultation fee; multidisciplinary medical care; outpatient radiotherapy; questionnaire survey