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Healthcare System of United States and Japan
This world is moving towards advancement in technology, science, and health, while human health is considered as the foundation because without humans it is not possible to move towards innovations and advancements. Healthcare system varies from country to country, time to time and organization to organization.
Response one
The United States and Japan. This paper will be discussing the healthcare systems of both nations.
Medication
The United States and Japan are two developed nations where there are many for health, education, and other basic needs. People have access to services like, healthcare, and there are different ways to access these services and avail them. People can avail medications they have some best healthcare systems. Both countries have different systems to provide medication services to patients.
The United States and Japan: Coverage to Medication
The United States is providing the best services in healthcare and medication, and people have coverage to the medication at their doorsteps. Medication in the United States is expensive, but people are given insurances. The spending on healthcare in the United States is increasing, and they continue to invest more in healthcare including medication services. While those who do not have access to medication, are provided with the insurances, and the medicines prescribed to them are given based on their willingness to pay ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"V09eGZhi","properties":{"formattedCitation":"(Levit et al., 2003)","plainCitation":"(Levit et al., 2003)","noteIndex":0},"citationItems":[{"id":160,"uris":["http://zotero.org/users/local/smYQhi21/items/M596SRBB"],"uri":["http://zotero.org/users/local/smYQhi21/items/M596SRBB"],"itemData":{"id":160,"type":"article-journal","title":"Trends in US health care spending, 2001","container-title":"Health Affairs","page":"154-164","volume":"22","issue":"1","author":[{"family":"Levit","given":"Katharine"},{"family":"Smith","given":"Cynthia"},{"family":"Cowan","given":"Cathy"},{"family":"Lazenby","given":"Helen"},{"family":"Sensenig","given":"Art"},{"family":"Catlin","given":"Aaron"}],"issued":{"date-parts":[["2003"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Levit et al., 2003). There are fixed subsidies for people belonging to low-income economies and they can avail insurance services as well.
When compared to Japan, which regulates all the services of healthcare, the government employees get their employee insurances, and subsidies are given to the local government. Japan is providing low-cost medications along with the insurances to maximum people. Japan provides medication to its all public at half of the cost which the United States is investing in its citizens ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"eBGOPBdm","properties":{"formattedCitation":"(Ikegami, 1991)","plainCitation":"(Ikegami, 1991)","noteIndex":0},"citationItems":[{"id":162,"uris":["http://zotero.org/users/local/smYQhi21/items/MK77XRV7"],"uri":["http://zotero.org/users/local/smYQhi21/items/MK77XRV7"],"itemData":{"id":162,"type":"article-journal","title":"Japanese Health Care: Low Cost Through Regulated Fees","container-title":"Health Affairs","page":"87-109","volume":"10","issue":"3","source":"healthaffairs.org (Atypon)","abstract":"Prologue:Japans health care system represents an enigma for Americans. The system incorporates features that Americans value highly: employment-based health insurance, free consumer choice of physician, and a delivery system that leaves clinical decision making in the hands of the doctor. But the cost of medical care in Japan is very low, compared with that in the United States, thus raising the question: How does Japan provide ready access to care for all of its citizens at a cost that is the lowest among major industrialized nations? In this essay, Naoki Ikegami describes the basic structure of the Japanese system, how it constrains expenditures, and the major issues it faces. Ikegami is a rare figure in the Japanese system because his interests span clinical medicine and health policy—a combination that is far more commonly found in the United States. Ikegami, who trained as a psychiatrist and started his research activities on the epidemiology of alcoholism, is a professor of health and public service management at Keio University in Tokyo. He also holds an appointment as professor of hospital and medical administration in Keio's School of Medicine, from which he received his medical degree. Ikegami received a master of arts degree in health services studies with distinction from Leeds University (United Kingdom). During 1990-1991, Ikegami was a visiting professor at the University of Pennsylvania's schools of medicine and business. Asked what lessons he derived from the experience, Ikegami said it allowed time “to ponder the pros and cons of opening the Pandora's box of managed care and micro-management in trying to evaluate the quality of care.” While at Penn, Ikegami also strengthened his research interests in the comparative analysis of policy and management in health care. He was the director of a course in comparative health care systems at Penn. Other research pursuits have included the management of long-term care and the evaluation of health care.","DOI":"10.1377/hlthaff.10.3.87","ISSN":"0278-2715","title-short":"Japanese Health Care","journalAbbreviation":"Health Affairs","author":[{"family":"Ikegami","given":"Naoki"}],"issued":{"date-parts":[["1991",1,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Ikegami, 1991).
The requirement to get a referral
United States: Process of referral can be divided into three parts: care coordination, decision making and access to medical or special care and the patients are required to get a
Referral. The patients while accessing special care, face difficulties and the patients feel frustrated ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"U2JfUVz4","properties":{"formattedCitation":"(Mehrotra, Forrest, & Lin, 2011)","plainCitation":"(Mehrotra, Forrest, & Lin, 2011)","noteIndex":0},"citationItems":[{"id":170,"uris":["http://zotero.org/users/local/smYQhi21/items/HYMUD24T"],"uri":["http://zotero.org/users/local/smYQhi21/items/HYMUD24T"],"itemData":{"id":170,"type":"article-journal","title":"Dropping the Baton: Specialty Referrals in the United States","container-title":"The Milbank Quarterly","page":"39-68","volume":"89","issue":"1","source":"PubMed Central","abstract":"Context: In the United States, more than a third of patients are referred to a specialist each year, and specialist visits constitute more than half of outpatient visits. Despite the frequency of referrals and the importance of the specialty-referral process, the process itself has been a long-standing source of frustration among both primary care physicians (PCPs) and specialists. These frustrations, along with a desire to lower costs, have led to numerous strategies to improve the specialty-referral process, such as using gatekeepers and referral guidelines., Methods: This article reviews the literature on the specialty-referral process in order to better understand what is known about current problems with the referral process and what solutions have been proposed. The article first provides a conceptual framework and then reviews prior literature on the referral decision, care coordination including information transfer, and access to specialty care., Findings: PCPs vary in their threshold for referring a patient, which results in both the underuse and the overuse of specialists. Many referrals do not include a transfer of information, either to or from the specialist; and when they do, it often contains insufficient data for medical decision making. Care across the primary-specialty interface is poorly integrated; PCPs often do not know whether a patient actually went to the specialist, or what the specialist recommended. PCPs and specialists also frequently disagree on the specialist's role during the referral episode (e.g., single consultation or continuing co-management)., Conclusions: There are breakdowns and inefficiencies in all components of the specialty-referral process. Despite many promising mechanisms to improve the referral process, rigorous evaluations of these improvements are needed.","DOI":"10.1111/j.1468-0009.2011.00619.x","ISSN":"0887-378X","note":"PMID: 21418312\nPMCID: PMC3160594","title-short":"Dropping the Baton","journalAbbreviation":"Milbank Q","author":[{"family":"Mehrotra","given":"Ateev"},{"family":"Forrest","given":"Christopher B"},{"family":"Lin","given":"Caroline Y"}],"issued":{"date-parts":[["2011",3]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Mehrotra, Forrest, & Lin, 2011).
Japan: Japan is providing healthcare and medication facilities to every citizen, however, there are no as such general physicians. Patients are either they are directly admitted, or they avail tertiary and secondary health services, and they are not required for any referral ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"zrVL3KSB","properties":{"formattedCitation":"(Toyabe & Kouhei, 2006)","plainCitation":"(Toyabe & Kouhei, 2006)","noteIndex":0},"citationItems":[{"id":166,"uris":["http://zotero.org/users/local/smYQhi21/items/8M6N46T4"],"uri":["http://zotero.org/users/local/smYQhi21/items/8M6N46T4"],"itemData":{"id":166,"type":"article-journal","title":"Referral from secondary care and to aftercare in a tertiary care university hospital in Japan","container-title":"BMC health services research","page":"11","volume":"6","source":"ResearchGate","abstract":"In Japan, all citizens are covered by the national insurance system in which universal free access to healthcare services is promised to everybody. There are no general physicians or gatekeepers in the Japanese healthcare system.\nWe studied the pattern of referral of inpatients from secondary care hospitals to a tertiary care university hospital and the reverse referral under the situations using a geographic information system (GIS), taking paediatric inpatients as an example.\nThe results showed that 61.2% of the patients were directly admitted to the hospital without referral from other hospitals or clinics and that 82.8% of the inpatients were referred to the outpatient department of the hospital to which they had been admitted. GIS analysis for the inpatients service area showed the hospital functions as both a secondary care hospital and tertiary care hospital. Patients who lived near the hospital tended to be admitted directly to the hospital, and patients who lived far from the hospital tended to utilize the hospital as a tertiary care provider. There were territorial disputes with other secondary care hospitals. To estimate spatial differences in referral to aftercare, we analyzed the spatial distribution of inpatients with focus on their length of hospital stay (LOS). GIS analysis revealed apparent foci of patients with long LOS and those with low LOS.\nThese results suggest that the function of university hospital in Japan is unspecialized and that the referral route from the university hospital to aftercare is also unequipped.","DOI":"10.1186/1472-6963-6-11","journalAbbreviation":"BMC health services research","author":[{"family":"Toyabe","given":"Shin-Ichi"},{"family":"Kouhei","given":"Akazawa"}],"issued":{"date-parts":[["2006",2,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Toyabe & Kouhei, 2006).
Coverage to healthcare systems
Patients or consumers in the healthcare system are provided with insurance, and subsidies for their medical treatments, and emergencies and they have given access to medication and healthcare services. However, the coverage for healthcare and medication both are different in the US and Japan like the healthcare system is best in the US, and the patients are required to ask for a referral, while patients in Japan are not required for the referrals although they also provide quality healthcare services.
Financial Implications for Patients
Japan: Patients in Japan are only required to pay a certain amount of expenses in hospitals, pharmacies, and clinics ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VJIlE5kw","properties":{"formattedCitation":"(Nakagawa & Kume, 2017)","plainCitation":"(Nakagawa & Kume, 2017)","noteIndex":0},"citationItems":[{"id":174,"uris":["http://zotero.org/users/local/smYQhi21/items/JWIKMY57"],"uri":["http://zotero.org/users/local/smYQhi21/items/JWIKMY57"],"itemData":{"id":174,"type":"article-journal","title":"Pharmacy Practice in Japan","container-title":"The Canadian Journal of Hospital Pharmacy","page":"232-242","volume":"70","issue":"3","source":"PubMed Central","ISSN":"0008-4123","note":"PMID: 28680178\nPMCID: PMC5491200","journalAbbreviation":"Can J Hosp Pharm","author":[{"family":"Nakagawa","given":"Sari"},{"family":"Kume","given":"Noriaki"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nakagawa & Kume, 2017). Medical are categorized according to the age groups, and those who are hospitalized for a longer period pay according to their job, and their age; 74 years pay 20 percent, and older than 74 years pay only 10 percent. While wholesalers purchase 97 percent of prescription drugs and the total was 8.4 million in the market ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"zAwnA9Ze","properties":{"formattedCitation":"(Nakagawa & Kume, 2017)","plainCitation":"(Nakagawa & Kume, 2017)","noteIndex":0},"citationItems":[{"id":174,"uris":["http://zotero.org/users/local/smYQhi21/items/JWIKMY57"],"uri":["http://zotero.org/users/local/smYQhi21/items/JWIKMY57"],"itemData":{"id":174,"type":"article-journal","title":"Pharmacy Practice in Japan","container-title":"The Canadian Journal of Hospital Pharmacy","page":"232-242","volume":"70","issue":"3","source":"PubMed Central","ISSN":"0008-4123","note":"PMID: 28680178\nPMCID: PMC5491200","journalAbbreviation":"Can J Hosp Pharm","author":[{"family":"Nakagawa","given":"Sari"},{"family":"Kume","given":"Noriaki"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nakagawa & Kume, 2017)
United States: People of 65 years or above are provided with advanced healthcare services, and medical care is divided into parts, i.e., part A, B, C and D. the total amount of 2.9 million dollars in spent, 255 per head in the healthcare system of United States. These categories medication to the patients and those who are eligible can avail of these medical services ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"DghxXiHL","properties":{"formattedCitation":"(Scott, 2016)","plainCitation":"(Scott, 2016)","noteIndex":0},"citationItems":[{"id":179,"uris":["http://zotero.org/users/local/smYQhi21/items/IM9YLL2I"],"uri":["http://zotero.org/users/local/smYQhi21/items/IM9YLL2I"],"itemData":{"id":179,"type":"article-journal","title":"United States Health Care System: A Pharmacy Perspective","container-title":"The Canadian Journal of Hospital Pharmacy","page":"306-315","volume":"69","issue":"4","source":"PubMed Central","ISSN":"0008-4123","note":"PMID: 27621491\nPMCID: PMC5008427","title-short":"United States Health Care System","journalAbbreviation":"Can J Hosp Pharm","author":[{"family":"Scott","given":"David M"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Scott, 2016).
References
BIBLIOGRAPHY ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Ikegami, N. (1991). Japanese Health Care: Low Cost Through Regulated Fees. Health Affairs, 10(3), 87–109. https://doi.org/10.1377/hlthaff.10.3.87
Levit, K., Smith, C., Cowan, C., Lazenby, H., Sensenig, A., & Catlin, A. (2003). Trends in US health care spending, 2001. Health Affairs, 22(1), 154–164.
Mehrotra, A., Forrest, C. B., & Lin, C. Y. (2011). Dropping the Baton: Specialty Referrals in the United States. The Milbank Quarterly, 89(1), 39–68. https://doi.org/10.1111/j.1468-0009.2011.00619.x
Nakagawa, S., & Kume, N. (2017). Pharmacy Practice in Japan. The Canadian Journal of Hospital Pharmacy, 70(3), 232–242.
Scott, D. M. (2016). The United States Health Care System: A Pharmacy Perspective. The Canadian Journal of Hospital Pharmacy, 69(4), 306–315.
Toyabe, S.-I., & Kouhei, A. (2006). Referral from secondary care and to aftercare in a tertiary care university hospital in Japan. BMC Health Services Research, 6, 11. https://doi.org/10.1186/1472-6963-6-11
