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Critical Shortage of Doctors JAPAN © World Health Organization 2017 ISBN 978 92 9061 818 8 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization (http://www.wipo.int/amc/en/mediation/rules). Suggested citation. Human resources for health country profiles: Japan. Manila, Philippines: World Health Organization Regional Office for the Western Pacific; 2017. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. 1. Delivery of health care – manpower. 2. Health manpower. 3. Health resources. 4. Japan. I. World Health Organization Regional Office for the Western Pacific Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing. For WHO Western Pacific Regional Publications, request for permission to reproduce should be addressed to Publications Office, World Health Organization, Regional Office for the Western Pacific, P.O. Box 2932, 1000, Manila, Philippines, Fax. No. (632) 521-1036, email: [email protected] Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user. General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. For inquiries and request for WHO Western Pacific Regional Publications, please contact the Publications Office, World Health Organization, Regional Office for the Western Pacific, P.O. Box 2932, 1000, Manila, Philippines, Fax. No. (632) 521-1036, email: [email protected] Human Resources for Health Country Profiles Japan Table of contents Acknowledgements viii Abbreviations ix Executive summary x 1. Introduction 1 1.1 Demographic, social and political background 1 1.2 Current economic situation 2 1.3 Summary of health indicators 3 1.4 Health-care administration 3 2. Health workforce stocks and trends 7 2.1 Health workforce supply 7 2.2 Health workforce distribution 9 3. Health professions education 15 3.1 Health professions education governance 15 3.2 Capacities of health professions education institutions 16 3.3 Admission and selection of students 17 3.4 Regulation and accreditation of health professions education institutions 19 3.5 In-service and continuing professional education 19 4. Human resources for health utilization 20 4.1 Recruitment 20 4.2 Deployment and distribution policies and mechanisms 20 4.3 Unemployment 20 4.4 Employment of health workers in the private sector 21 4.5 Health workforce performance 21 5. Financing human resources for health 21 5.1 Human resources for health expenditure 21 5.2 Remuneration to health workers 22 5.3 Financing health professions education 24 6. Governance for human resources for health 25 6.1 Policies and plans 25 6.2 Policy development, planning and management 25 6.3 Professional registration 25 6.4 Human resources for health information 26 6.5 Health workforce demands 26 7. Concluding remarks 26 Endnotes 38 Annexes 28 Annex 1. Human resources for long-term care 28 Annex 2. OECD definition of rural areas 31 Annex 3. International Standard Classification of Occupations (ISCO 2008) 32 List of figures Figure 1. Regions and administrative divisions of Japan .................................................................................. 1 Figure 2. Population change in Japan .............................................................................................................. 2 Figure 3. Leading causes of death in Japan ...................................................................................................... 3 Figure 4. Health-care administration ............................................................................................................... 4 Figure 5. Hospitals by type and number of beds ............................................................................................. 4 Figure 6. Insured medical treatment system .................................................................................................... 5 Figure 7. Insurance system, payment for services and remuneration for service providers .............................. 5 Figure 8. Changes in medical care expenditure ............................................................................................... 6 Figure 9. Ratio of male to female doctors by age group .................................................................................. 9 Figure 10. Age distribution of health workers by health profession (2012) .................................................... 10 Figure 11. Health-care workers by region (2012) ........................................................................................... 12 Figure 12. Improving access to health care in remote areas .......................................................................... 13 Figure 13. Undergraduate studies and postgraduate clinical training for doctors .......................................... 15 Figure 14. Undergraduate studies for nurses................................................................................................. 16 Figure 15. Medical fee structure of medical institutions ................................................................................ 21 Figure 16. Average monthly wages for nurses and practical nurses by prefecture (facilities with 10 or more employees) .......................................................................................... 23 Figure 17. Structure of the Health Policy Bureau, Ministry of Health, Labour and Welfare .............................. 25 Figure A1. Mechanisms of the long-term care insurance system .................................................................... 29 Figure A2. Educational pathway for a care worker ......................................................................................... 30 vi Human Resources for Health Country Profiles List of tables Table 1. Selected demographic characteristics ................................................................................................ 2 Table 2. Selected economic and socioeconomic characteristics ....................................................................... 2 Table 3. Selected health indicators .................................................................................................................. 3 Table 4. Selected health expenditure indicators............................................................................................... 6 Table 5. Current supply of health workers at national level ............................................................................. 8 Table 6. Gender distribution by health profession (2012) ................................................................................ 9 Table 7. Age distribution of health workers by health profession (2012) ....................................................... 10 Table 8. Health workers by health profession and region/district/province (2012) ........................................ 11 Table 9. Hospital beds by region (2013) .......................................................................................................
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