Japan's health care system: Containing costs and attempting reform
Japan's health care system: Containing costs and attempting reform
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DOI：
10.1377/hlthaff.23.3.26
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发表时间：
2004-05-01
期刊：
影响因子：
9.7
通讯作者：
Campbell, JC
中科院分区：
文献类型：
--
作者：
Ikegami, N;Campbell, JC
随着日本经济的衰退，通过收费表对价格甚至数量进行了更严格的控制，加上各种共同负担率的提高，导致2002年医疗支出有史以来第一次实际减少。为了加强现有的成本控制机制，2003年在大学医院实行了基于病例组合的住院治疗包容性收费，并计划用于亚急性和长期护理。但是，其他领域不太可能进行实质性的改革，包括引进市场化的药品。在使提供系统对病人更加负责方面取得了有意义的进展，但进展缓慢。
As Japan's economy declined, more intensive control of prices and even volume through the fee schedule, plus increases in various copayment rates, led to an actual reduction of medical spending in 2002 for the first time in history. To augment established mechanisms of cost containment, case-mix-based inclusive fees for inpatient care were introduced in university hospitals in 2003 and are planned for subacute and long-term care. However, substantial reform, including the introduction of market-based medicine, is not likely to occur in other areas. Progress in making the delivery system more accountable to patients has been meaningful but slow.