It is important to improve the efficiency of hospitals that support regional medical services while maintaining the quality of the services they provide.
The Health, Labor and Welfare Ministry has announced the names of 424 hospitals run by regional governments and central government-authorized entities across the nation that have been judged to require discussions on reorganization or consolidation.
The list includes hospitals that handle few cases of treatments that are considered to be essential to regional health care facilities, such as cancer and emergency care. It also includes hospitals that are located near institutions that provide similar services.
The goal is to make medical services more efficient and put a brake on rising health care costs.
Many regional governments have been reluctant to reorganize hospitals, fearing a backlash from local residents. The ministry's move to name the hospitals is probably aimed at sparking debate on the issue.
In 2025, the baby boomers will have reached the age of 75 or older, which will cause medical expenses to balloon. Thus reorganizing hospitals is an urgent task.
Public hospitals are experiencing financial difficulties -- 60 percent of them are in the red. From the viewpoint of local government finances, it is unavoidable to review the management of public hospitals.
The ministry wants the matter to be discussed at meetings held by prefectural and municipal governments and medical institutions to coordinate local medical services. It wants discussions to be concluded by September next year.
There are various options regarding how hospitals could be reorganized. Through cooperation with neighboring hospitals, functions to treat severe diseases can be downscaled. Departments with low patient numbers can be reduced, and the freed up resources used to improve insufficient medical services.
The needs in each region have to be considered. In order to maintain local hubs for medical services, it is indispensable to consolidate functions and review facilities that have excessive numbers of hospital beds or departments.
Needless to say, the role public hospitals must continue to play in remote areas is significant. It is vital to protect the provision of essential medical services as a principle. The division of services in alignment with private hospitals should also be considered.
As life spans increase, the number of people suffering from chronic conditions such as lifestyle-related diseases is rising. Hospital beds for patients with acute illnesses requiring operations will decrease, while beds for convalescents undergoing rehabilitation will increase. A shift from health care services that heal patients to services that support life will be needed.
It is important to comprehensively consider a system to provide regional medical services, including home care services.
Nara's prefectural government took the initiative in reorganizing the function of three public hospitals in the prefecture. As a result, seamless medical services became widely available. The occupancy rate of beds has gone up and the number of patients treated has increased. The internship system has also improved, making it easier for junior doctors to work at the hospitals.
Using such a case as a reference, it is hoped that local governments will accelerate deliberations on hospital reorganization.
The government will set a limit on overtime hours for salaried doctors in fiscal 2024 as part of its work style reforms.
If hospital reorganizations make it possible for a patient to be treated by several doctors, it could fix the problem of long working hours. For regional hospitals to secure doctors, they must also consider improving work conditions.
(From The Yomiuri Shimbun, Oct. 13, 2019)
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