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No. 30 July 2011 July 2011 No. 30 July 2011 Special Feature Collaborative Work among Healthcare Professionals and the Regeneration of Hospital Care Tsuneo SAKAI Reaching toward a Bright Future for the Japan Hospital Serial Number 30 Serial Number Association (JHA)—Healthcare Cost Reduction Policy Breakthrough <A local hospital director’s efforts> Kimio HENMI No.30 July 2011 JAPAN HOSPITALS The Journal of Japan Hospital Association Contents Foreword Tsuneo Sakai 1 Special Feature Collaborative Work among Healthcare Professionals and the Regeneration of Hospital Care Tsuneo Sakai 3 Reaching toward a Bright Future for the Japan Hospital Association (JHA)—Healthcare Cost Reduction Policy Breakthrough <A local hospital director’s efforts> Kimio Henmi 15 Submitted Articles Medical Tourism —Why Are Japanese Hospitals Still Incapable, Resistive or Opposed to Competing in this Global Trend? John C. Wocher 41 Crisis of Novel Infectious Diseases: Why Don’t Japan Have Enough Vaccines? Koichi Kawabuchi 53 Effect on Self-esteem of Workshop to Induce Laughter through Praise Kazue Takayanagi 61 Preventive Care Strategies Based on Disease Prevalence among Japanese Urban Elderly: Focus on Disease Prevention in Mildly Frail Elders with Long-term Care Insurance Kiichiro Onishi 67 Main Medical Conditions of Frail Elderly Patients that Require Intensive Care under the Japanese Long-Term Care Insurance (LTCI) System: A Comparison with German LTCI Kiichiro Onishi 77 Japan Hospital Association is committed to contributing to society by enhancing hospital services in Japan. This journal introduces the activities of the Association and healthcare in Japan to the world. Enquiries regarding the Association and its services should be addressed to: Japan Hospital Association Ichibancho 13-3, Chiyoda-ku, Tokyo 102-0082, Japan Tel: 03-3265-0077 Fax: 03-3230-2898 Email: [email protected] Editorial Board Journal and Newsletter Editorial Committee of the Japan Hospital Association Dr. Kazuo HOSHI Editorial Cooperation faro inc. 6-15-1-5F, Kasai bld. Hon-komagome, Bunkyo-ku, Tokyo 113-0021, Japan Tel: 03-6380-4888 Fax: 03-6380-5121 http://www.faroinc.com Copyright 2011 Japan Hospital Association Foreword Tsuneo Sakai President, Japan Hospital Association I feel the weight of my responsibility as the association prepares to mark its 60th anniversary next year and recognize the importance of focusing my energies on meeting the needs of JHA member hospitals. It is my hope to provide the caliber of leadership that serves to advance the role and effectiveness of the JHA as we move into the future while upholding the high ideals and traditions of those who have guided the JHA over the past 60 years. Our healthcare system is collapsing around us, and hospitals in particular are facing severe challenges in their bid to continue providing adequate services as changes in our nation’s leadership have caused uncertainty for the future of our community. It is time, therefore, for the JHA to set its sights on the regeneration of hospital care as an organization representing the needs of a membership that is diverse and which exhibits different characteristics in terms of the parent organizations involved, type of healthcare offered, scale, and location. Keeping in mind what member hospitals require from the JHA, what patients treated at member hospitals require from the JHA, and what the government expects from the JHA, we need to pursue evidence-based projects. Of course, it is impossible to achieve results in a short period of time, so we are striving to show step- by-step progress toward improvement. The association’s goals are spelled out in the article of incorporation; however, because it is difficult to cover everything, it is necessary for us to narrow our priorities. This year, the activities of the association’s committees will focus on 1. The regeneration of hospital care; 2. An examination of the healthcare insurance and fee systems; 3. Approaches to the improvement of healthcare and safety; 4. The cultivation of human resources; 5. Promoting the provision of information; 6. Approaches for implementation of the new public-interest corporation; 7. Reorganization of hospital organizations; 8. Commemorative projects to celebrate the JHA’s 60th anniversary; and 9; Enhancement of the secretariat. Among these activities, we consider three items to be high-priority issues: (1) The cultivation of human resources to ensure the quality of healthcare services and the promotion of hospital management efficiency, (2) The regeneration of regional healthcare through regional cooperation, and (3) The gathering and disseminating of information. Hospitals are groups of specialists. These specialists are required to acquire specialized knowledge and skills. In addition, it is also important to cultivate human resources to ensure the quality of healthcare services and improve the efficiency of hospital management. It is often said that healthcare is a regional industry, and because of this we need to consider the provision of seamless healthcare through cooperation suitable for each region not only from the macroeconomic perspective, but also from the microeconomic perspective. There is an asymmetry of information between patients and care providers, and unfortunately, there is also an asymmetry of information between the executive office and JHA member hospitals. We need to visualize information. We need to examine what data are required, and collect and analyze such data for the benefit of member hospitals. We must also consider the need and potential for the creation of a database from which policy proposals can be made. I am counting on your support as the JHA moves forward into the future. Japan Hospitals No. 30 / July 2011 1 Special Feature Gifu, July 2010 The 60th Japan Hospital Association Congress Collaborative Work among Healthcare Professionals and the Regeneration of Hospital Care Tsuneo Sakai Director, Seirei Hamamatsu General Hospital President, Japan Hospital Association Chairperson (Dr. Yamada): We now move to the President’s address. Main Points Please allow me to introduce Tsuneo Sakai, President of Issues hospitals are currently facing Japan Hospital Association. Dr. Sakai graduated from the Regenerating hospital care medical department of Chiba University in March 1970. Basic role of healthcare He attended New York State University at Syracuse, New Role of each organization What the Japan Hospital Association has planned York, in 1979 and graduated from the State University of Conclusion New York Upstate Medical University Graduate School in 1987. He completed his internship at United States Army Slide 1 Medical Center at Camp Zama in 1970. After finishing a residency in neurosurgery in the U.S., he joined the issues hospitals are currently facing and consider what we Hamamatsu University School of Medicine Department of can and should do for the regeneration of hospital care. I Neurosurgery in 1979, assumed the position of Assistant would then like to take advantage of this opportunity and Director of Seirei Mikatahara General Hospital in 1981, talk about what the Japan Hospital Association might do and assumed the position of Assistant Director of Seirei in response to the situation at hand. Hamamatsu General Hospital from 1992. Since 1996, he has held the position of Director of Seirei Hamamatsu n Issues hospitals are currently General Hospital. facing As you are all well aware, he is currently President of l Hospitals cannot make decisions alone. the Japan Hospital Association. He also devotes his time (Slide 2) There are various issues that hospitals currently and energy to other organizations. Now, however, in the face and need to deal with. As you already know, however, interest of time, please welcome Dr. Sakai. healthcare involves more than just the professionals who provide it. Decisions affecting the healthcare system also Dr. Sakai: Thank you so much for your kind involve the society which it serves, the public as well as the introduction, Dr. Yamada. Today, I would like to talk about government at national and local levels all providing input “collaborative work among healthcare professionals and and guidance in the form of instructions and regulations. the regeneration of hospital care.” Hospitals alone are not in a position to make decisions (Slide 1) First of all, please allow me to give you a that will affect the direction of healthcare; and even with rough outline of my address. I want to summarize the recent government initiatives designed to improve the situation, hospitals still find themselves facing severe conditions with no relief in sight. Seminar Chairman: Chairperson & Director, Kizawa Memorial Hospital Director, The 60th JHA Congress Jitsuhiro Yamada Japan Hospitals No. 30 / July 2011 3 reason for this is that medical treatment fees are too low. I Issues hospitals are currently facing suspect that all of you here are experiencing the reality of Hospitals cannot make decisions alone. this situation on a daily basis as you work hard to deliver A triangle of healthcare services (stakeholder) the best care under trying conditions. ? Political initiative The cost of running a hospital can be divided into three Treatment and management are both important. categories: basic, ordinary, and indirect expenses. Basic Hospitals are in a financially unsustainable condition. FY 2009 hospital management statistical data shows expenses include the cost of hospital construction and the that 68.8% of hospitals are operating at a deficit. purchase of equipment.
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