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Overview of Health and Medical Care System in Japan

Overview of Health and Medical Care System in Japan. JICA Tokyo International Center December 2006. Outline. Health/Medical Services Laws --- 3 Health Services ---------------- 4-14 Medical Services ------------- 15-18 Health Insurance System --- 19-22. Health/ Medical Services Laws.

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Overview of Health and Medical Care System in Japan

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  1. Overview of Health andMedical Care System in Japan JICA Tokyo International CenterDecember 2006

  2. Outline • Health/Medical Services Laws --- 3 • Health Services ---------------- 4-14 • Medical Services ------------- 15-18 • Health Insurance System --- 19-22

  3. Health/ Medical Services Laws Laws regulate medical services to guarantee the equal and proper supply. • Institutional aspect - Medical service Law, etc • Professional activity - Medical Practitioners Law, etc • Drug and medical device control - Pharmaceutical Affairs Law Laws for some medical practices and health services • Psychiatric disease - Mental Health Law • Infectious diseases - Infectious Diseases Prevention Law • Tuberculosis Control - Tuberculosis Control Law • Immunization - Immunization Law • Insurance - Health Insurance Law • Community health - Regional Health Law etc… Source: JICA(2001)

  4. Health Service System ・National Policies/Programs ・Budget Ministry of Health, Labour and Welfare 47 Prefectual Governments*, 139 Large Municipal Governments* ・RegionalHealth Medical plan ・Budget Catchments areas for secondary medical care:365 (March 2006) Public Health Centers (Hoken-jo) 535(April 2006) 1820(April 2006） ・Provision of Preventive Health Services (Promotion, sanitation, medical pharmaceutical affairs, statistics, risk management) ・Technical support ・Provision of Health /Welfare Services ・Budget Municipal Governments* (city, town, village) 2692(April 2006） Municipal Health Centers (Hoken-center) ・Health services for the aged ・Immunization ・MCH checkup * Local governments Community People Source:NIPH(2005)

  5. Ministry of Health Labour, and Welfare Role: To make policies and programs for establishment and maintenance of various systems for health, medical care and welfare services. National Government Policy, Laws and budget National level service system Local Government People in the community Source:JICA(2001)

  6. Local Governments Role : Establishment of effective health service system in cooperation with health/medical service agencies (public and municipal health centers, hospitals) National Government Local Government Rules and Budget Management of health service and medical care service People in the community Source:JICA(2001)

  7. Public Health Center (1) Role: to plan, supervise and evaluate health programs at responsible area. Fields of activities:health education, demography and health statistics, improvement of nutrition and food hygiene, safe water supply and waste management, promotion of public medical services, maternal and child health, oral hygiene, and control of disease including sexually transmitted infections and tuberculosis control. Source:NIPH(2005),HWSA(2005)

  8. Public Health Center (2) Source:JPHA(2004)

  9. Public Health Center (3)

  10. Municipal Health Center(1) • Role: to provide health services directly to the residents at the municipal (cities, towns, villages) level. • Activities: more closely related with daily life than those public health centers do, such as health counseling, health advice, health checkups, and so on. • Target population is selected based on resident registration and services are announced by newsletters and mails. Source:JPHA(2004)

  11. Municipal Health Center(2) Source:JPHA(2004)

  12. Municipal Health Center(3)

  13. Maternal and Child Health Services Pregnancy Registration at City hall Examination at Clinics/hospitals Pregnancy MCH hand book Birth Registration at City hall Mass screening Delivery Parents’ class Baby’s Health Check-ups Baby’s Immunization Home visit service at hospitals/clinics/MHCs *Blue ink: related to the public health services *MHCs (Municipal Health Centers) Source:JICA(2006)

  14. Health Services in the Life Cycle Community Based public health /School health/Occupational health Local governments (prefectual, municipal) /Schools/Employer/Insurer 3years old examination 18month examination Infant examination Health check-ups for pregnant women and new mothers, and health guidance Public health programs for the elderly, health education, health consultation, health check-ups, occupational therapy, home visit counseling Women’s health checks and nutritional guidance Regulartuberculosis screening Preschool examinations and health guidance Health check-ups at school entry and at regular intervals Rural health maintenance guidance program (health education, health checks, health guidance and consultation) Occupational health and safety Workplace health programs Source:JICA(2004)

  15. Definition of Medical Institutions • Hospitals: Established by doctors or dentists, with inpatient beds (20 or more) to provide medical services. • Clinics: Medical institutions without beds or with less than 20 beds. • Midwifery practices: Medical institutions for delivery and care related to delivery by a midwife, with less than 10 beds. Source:JICA(2001)

  16. Number of Medical Institutions by Founder As of October 2004 Number of Hospitals National Governments：304 Local Government and Other: 1,506 Private: 7,267 Total: 9,077 Number of Clinics National Governments： 620 Local Government and Other: 4,895 Private: 91,536 Total: 97,051 Source:IMCJ(2005)

  17. Medical Care Plans Formulated by Local (prefectural) governments for: • appropriate allocation of medical resources • share of functions and cooperation among healthcare related institutions • promotion of the systematic improvement of high-quality community healthcare Source：JICA(2003),HWSA(2005)

  18. Access to Medical Services • Universal access to any type of medical institutions. • Substantial portion of medical care is provided by the primary care physician (at a clinic). • Tendency to go to a big hospital because of its excellent facilities and personnel. Source:JPHA(2004)

  19. Health Insurance System(1) • In 1961, the “Universal National Health Insurance System” was established. And it applies to the entire population of the nation. • Whole cost was used to be covered in the past. But now mostly 70% is covered and patients are required to pay a certain amount (30%) Source:JICA(2003),HWSA(2005)

  20. Health Insurance System(2) • The Employee’s Health Insurance (EHI) - Health Insurance Societies (HIS) - the Social Insurance Agency (SIA) - Mutual Aid Association (MAA) • The National Health Insurance (NHI) - municipal governments - NHI societies Source:JPHA(2004)

  21. Health Insurance System(3) Proportion of insurers Employees Health Insurance (SIA, HIS, MAA) covers 60% of the population. (March 2004) Source:JPHA(2004)

  22. Concept Chart of Insured Medical Care Medical Service Insured person (patient) Payment of premium Payment of partial cost-sharing amount Medical institutions (hospital/clinic) Insurer Claim of examined amount Claim of medical fee Examination and payment organization Reimbursement of requested amount Reimbursement of medical fee Payment fund / National Health Insurance Group Association Source:IMCJ(2005)

  23. Thank you!

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