Bottom-Up Approach to Establish Coordination Mechanisms for Disaster Preparedness Among Largely Private Health-Care Providers in Central Tokyo

doi:10.1017/dmp.2021.326

Abstract

In Japan, despite its private-dominant and disjointed health-care system, national initiatives to coordinate various types of health-care facilities are lacking. Municipal governments manage this task with limited resources. This study describes a successful example of a bottom-up approach to create city-wide collaboration for disaster preparedness. In Minato City, located in central Tokyo, a group of physicians created a project involving a city-wide disaster medical care drill. The city Public Health Center, in charge of health-care systems including disaster medicine, helped the group to increase proponents of the project. The city-wide disaster drill started in November 2017; thereafter, the drills were held every year. Participation in drills by various health-care personnel helped establish a city-wide system for disaster medical care, coordination mechanisms among stakeholders, increased motivation among health-care personnel, and development of in-hospital systems. This approach is flexible and applicable to various forms of health-care systems in other areas.

Highlights

Such mechanisms are underorganized in Japan for 2 main reasons: first, the national government has no specific initiatives or funds for this purpose, and municipal governments are in charge of disaster medical care and may allocate their own small budgets; second, a large number of small-sized private organizations provide health care throughout the country, contributing to good health-care access under the public health insurance system
A city-wide disaster medical care drill project in central Tokyo has succeeded in forming collaborations between various health-care providers and the municipal government, it is still in the early stage of coalition development
Physicians involved in disaster medical care planning in Minato City shared their perception that effective collaboration mechanisms and disaster drills were lacking and that disaster plans needed to be realized to address issues revealed in the frequent disasters of the early 2010s

Summary

Introduction

In Japan, similar coordination mechanisms are required for disaster preparedness because of the country’s private-dominant health-care system and frequent natural disasters, including earthquakes and floods.[3,4] such mechanisms are underorganized in Japan for 2 main reasons: first, the national government has no specific initiatives or funds for this purpose, and municipal governments are in charge of disaster medical care and may allocate their own small budgets; second, a large number of small-sized private organizations provide health care throughout the country, contributing to good health-care access under the public health insurance system. Central Tokyo Medical District* Regional Coordination Council for Disaster Medical Care (Members are representatives of local medical associations, local dental associations, local pharmaceutical associations, disaster base hospitals, municipalities, and municipal public health centers) The Minato Public Health Center serves as the headquarters for disaster medical care management and coordination.

Results

Conclusion