Monday, November 9, 2009

[EQ] Japan Health System Review

Japan Health System Review


Health Systems in Transition

Kozo Tatara, Open University of Japan

Etsuji Okamoto, Department of Management Sciences, National Institute of Public Health

Sara Allin, European Observatory on Health Systems and Policies

Ryozo Matsuda, Ritsumeikan University, Kyoto, Japan

The European Observatory on Health Systems and Policies
- World Health Organization Regional Office for Europe, 2009

Available online PDF [179p.] at: http://www.euro.who.int/Document/E92927.pdf

 

“…….Japan’s health system provides universal coverage of the population through health insurance system for employees and their families (60% of the population) and National Health Insurance (NHI) system for the self-employed, retired and unemployed (40%). Annual expenditure is around 8% of gross domestic product (GDP) according to OECD estimates, and the main funding mechanisms are health insurance (50% of total spending), taxation (36%) and out-of-pocket payments (14%).

Population health in Japan is among the best in the world, with the longest life expectancy and lowest infant mortality. The population has aged considerably, with over 21% aged 65 years or older. Recent health system reforms are related in large part to this demographic challenge, such as the introduction of an independent financing system for the oldest-old population cross-subsidized by all health insurers, better integration of preventive services into the insurance system, reforming the methods of paying hospitals and the introduction of a new system of long-term care fi nanced through insurance and administered by municipal governments……”

 

“……Japan’s annual health care spending is estimated to be 32.1 trillion yen in 2005, or 259 300 yen per capita (approximately US$2600), accounting for 6.6% of gross domestic product (GDP) according to national estimates and 8% from estimates of the Organisation for Economic Co-operation and Development (OECD), which include private payments. The three major methods of fi nancing are health insurance (49.2% of total health spending), provided by more than 3500 separate insurance funds, general taxation (36.4%) and out-of-pocket payments (14.4%).

Japan’s statutory health insurance system is administered by a multitude of insurers: the government (from October 2008, a quasi-governmental body, the Japan Health Insurance Association) for employees of small to medium-sized fi rms and their dependants, 1584 Society-managed Health Insurance funds for employees of large fi rms and their dependants, 76 Mutual Aid Society (MAS) funds for government employees and dependants, 1835 municipal National Health Insurance funds for the self-employed, retired and unemployed, and 166 National Health Insurance Society funds for some occupational groups such as doctors and lawyers, each with different premium contribution rates.

The contribution rate of Government-managed Health Insurance is 8.2% of monthly gross salary equally shared between employers and employees….”

 

Content

Executive summary

1. Introduction

1.1 Geography and sociodemography

1.2 Economic context

1.3 Political context

1.4 Health status

2. Organizational structure

2.1 Overview of the health system

2.2 Historical background

2.3 Organizational overview

2.4 Decentralization and centralization

2.5 Patient empowerment

3. Financing

3.1 Health expenditure

3.2 Population coverage and basis for entitlement

3.3 Sources of funds

3.4 Pooling of funds

3.5 Purchasing and purchaser–provider relations

3.6 Payment mechanisms

4. Regulation and planning

4.1 Regulation

4.2 Planning and health information management

5. Physical and human resources

5.1 Physical resources

5.2 Human resources

6. Provision of services

6.1 Public health

6.2 Patient pathways

6.3 Primary/ambulatory care

6.4 Inpatient care

6.5 Health care for the elderly

6.6 Emergency care

6.7 Pharmaceutical care

6.8 Long-term care

6.9 Mental health care

6.10 Dental care

6.11 Complementary and alternative medicines

6.12 Health care for specific populations

7. Principal health care reforms

7.1 Analysis of recent reforms

7.2 Future developments

8. Assessment of the health system

8.1 Objectives of the health system

8.2 Distribution of costs and benefits across the population

8.3 Efficiency of resource allocation

8.4 Technical efficiency

8.5 Quality of care

8.6 Contribution of the health system to health improvement

9. Conclusions

10. Appendices

10.1 References

10.2 Principal legislation

10.3 Useful web sites

10.4 HiT methodology and production process

10.5 The review process

 

*      *     *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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[EQ] WHO Global Report: Women and health: today's evidence tomorrow's agenda

Women and health: today's evidence tomorrow's agenda

Despite progress, societies continue to fail women at key times of their lives

World Health Organization - 2009
ISBN: 9789241563857

Available online PDF [108p.] at: http://whqlibdoc.who.int/publications/2009/9789241563857_eng.pdf


Download executive summary [pdf 497kb]

“…….Despite considerable progress in the past decades, societies continue to fail to meet the health care needs of women at key moments of their lives, particularly in their adolescent years and in older age. These are the key findings of the WHO report Women and health: today's evidence tomorrow's agenda.

 

WHO calls for urgent action both within the health sector and beyond to improve the health and lives of girls and women around the world, from birth to older age.

 

The report provides the latest and most comprehensive evidence available to date on women's specific needs and health challenges over their entire life-course. The report includes the latest global and regional figures on the health and leading causes of death in women from birth, through childhood, adolescence and adulthood, to older age…..”

 

Content

Executive summary

Chapter 1 Understanding women’s health in the world today

Women around the world

Increasing life expectancy

The health transition

Socioeconomic inequalities adversely affect health

Gender inequities affect women’s health

Women amid conflicts and crisis

Women and the health-care system

Chapter 2 The girl child

Still too many deaths of infants and children

Sex differentials in health

Female genital mutilation

Abuse and maltreatment

Chapter 3 Adolescent girls

A time of good health but also risk

Puberty and sexual debut

Adolescent pregnancy

Sexually transmitted infections

Substance use

Poor diet and physical inactivity

Mental health in adolescence

Chapter 4 Adult women: the reproductive years

Women’s health during the reproductive years

Maternal health

Women and HIV/AIDS

Sexually transmitted infections

Cervical cancer

Chapter 5 Adult women

Mortality and burden of disease

Women, depression and suicide

Risk factors for chronic disease

Violence

Illness and use of health services

Chapter 6 Older women

Women and ageing

Socioeconomic influences on health in older women

What are the health problems that older women face?

Managing disabilities – a matter of prevention and care

Caring for older women

Chapter 7 Policy implications

Leadership

Responsive health services

Universal coverage

Public policy

Tracking progress

Index

 

 

*      *     *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
PAHO/WHO Website

Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
Twitter http://twitter.com/eqpaho

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.