International Comparison of Reform of Regional Healthcare Provider Systems (Establishing Integrated Healthcare Networks)

ABSTRACT

How to deal with the collapse of the healthcare system is expected to be the strongest point of contention in Japan’s next general election. The collapse of the healthcare system can be broadly divided into two main problems: funding issues surrounding the healthcare system for the elderly, and the problem of regional healthcare provider systems largely attributable to the shortage of doctors. Regarding the problem of healthcare funding, it is possible that policy aimed at controlling healthcare costs, continued since the Koizumi administration, will be reviewed. In addition to the growing recognition that this policy has played a part in the collapse of the healthcare system, an increase in healthcare expenditure can also help to stimulate the economy. However, without the reform of local government hospitals, the central player in the collapse of regional healthcare provider systems, the positive effect of additional healthcare expenditure on the Japanese economy would be short-lived.

Meanwhile, in other developed countries such as the US, Britain, Canada and Australia, sweeping reform of public hospitals is already underway and the reconstruction of regional healthcare provider systems is being promoted. What these countries have in common is the establishment of unified frameworks for governance and decision-making for the optimal allocation of healthcare budgets for broad healthcare coverage areas. Creating networks among healthcare-related facilities with differing functions is an effective way to improve the economic effects of unified decision-making. In the US, such regional healthcare networks are called Integrated Healthcare Networks (IHN). The essence of IHN is to avoid overlapping investment by sharing healthcare resources, and at the same time promote the standardization of healthcare. Regional healthcare networks in Britain, Canada and Australia are being established with the same IHN essence. This paper compares overviews of regional healthcare provider systems and public hospital reform in each country, and searches for clues for healthcare reform in Japan.