Direction of quality improvement activities of health care organizations in Japan.

Abstract

Listen

Translate article

Since Japan introduced a universal health insurance system care organizations by conducting surveys using third-party evaluation methods. based on fee-for-service in 1961, the health status of the people of Japan has dramatically improved. Japan has achieved the world’s longest life expectancy at a fairly reasonable cost. People can access care regardless of their capacity to pay and Birth of quality improvement activities can select any services without restrictions. Now there are some 9800 hospitals and 84 000 clinics throughout the counDespite a relatively short history compared with that of try. Please note that in Japan, health care organizations with JCAHO in the USA [3], quality improvement activities in 20 or more beds are defined operationally as hospitals and Japanese health care organizations are growing rapidly (Figure those with less than 20 beds as clinics [1]. 1). Japan still ranks among the lower half of advanced countries In 1985, a committee was set up by the Japanese Medical in the ratio of total health expenditure to the gross domestic Association and the Ministry of Health and Welfare to develop product [2]. However, like other developed countries, Japan the self-check manual for health care organizations, and a faces a fiscal crisis: due to a rapidly ageing population and survey of performance was conducted using the evaluation fewer children, the 21st century is likely to be named ‘the items that had been developed in 6433 participating hospitals century of the elderly’. As the economic pressure increases, (67.2% of the 9567 existing hospitals). The self-check manual issues such as the growing number of physicians entering consists of five categories (structure, role in the community, practice, the longer length of hospital stay and heavy use patient satisfaction, scientific basis and management) and of prescriptions by physicians become more controversial. contains 100 items. This was the first attempt to ensure the Finally, in response to these problems, attention is being paid delivery of high quality care, and the basic framework of this to the quality of health care, in order to provide optimal care manual was used in the third-party evaluation method in at reasonable costs. 1990s. The Japanese Society for Quality in Health Care (JSQua) has taken a leading role in the quality improvement activities of health care organizations since 1990. JSQua developed a third-party evaluation system based on the idea of forming Growing interest in third-party a study group in the Private Hospital Association to study the activities of the Joint Commission on Accreditation of evaluation – JSQua Healthcare Organizations (JCAHO) in the USA. In 1995, the Japanese Council for Quality Health Care (JCQHC) was In 1987, the Private Hospital Association organized a study group with a few scholars. This group studied the overall founded with the aim of improving the quality of health