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Investigating the health care delivery system in Japan and reviewing the local public hospital reform

Authors Zhang X, Oyama T

Received 31 July 2015

Accepted for publication 3 November 2015

Published 18 March 2016 Volume 2016:9 Pages 21—32

DOI https://doi.org/10.2147/RMHP.S93285

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Mary Schmeida

Peer reviewer comments 3

Editor who approved publication: Professor Frank Papatheofanis

Xing Zhang, Tatsuo Oyama

National Graduate Institute for Policy Studies, Tokyo, Japan

Abstract: Japan's health care system is considered one of the best health care systems in the world. Hospitals are one of the most important health care resources in Japan. As such, we investigate Japanese hospitals from various viewpoints, including their roles, ownership, regional distribution, and characteristics with respect to the number of beds, staff, doctors, and financial performance. Applying a multivariate analysis and regression model techniques, we show the functional differences between urban populated prefectures and remote ones; the equality gap among all prefectures with respect to the distribution of the number of beds, staff, and doctors; and managerial differences between private and public hospitals. We also review and evaluate the local public hospital reform executed in 2007 from various financial aspects related to the expenditure and revenue structure by comparing public and private hospitals. We show that the 2007 reform contributed to improving the financial situation of local public hospitals. Strategic differences between public and private hospitals with respect to their management and strategy to improve their financial situation are also quantitatively analyzed in detail. Finally, the remaining problems and the future strategy to further improve the Japanese health care system are described.

Keywords: health care system, health care resource, public hospital, multivariate regression model, financial performance

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