scholarly journals Preliminary Examination of an Appropriate Price Calculation Method and Medical Treatment Costs for Foreign Visitors in Japan

2021 ◽  
Vol 18 (11) ◽  
pp. 5837
Author(s):  
Tomoyuki Takura ◽  
Keyword(s):  
Medical Treatment ◽  
Price Level ◽  
Femoral Fractures ◽  
Japanese Patients ◽  
Insurance Companies ◽  
Public Healthcare ◽  
Preliminary Examination ◽  
Two Stages ◽  
External Injury ◽  
Japanese Tourists

This study proposes a method for calculating the appropriate medical treatment price level for foreign visitors (FVs) in Japan. Hospital management costs and foreign prices were analyzed from a market principles perspective to determine the medical treatment price. The study involved two stages: a preliminary survey and an extended survey, supplemented by an international survey. Relatively frequent diseases were selected, and the costs incurred by hospitals for the treatment of FVs were analyzed though data from three hospitals, covering 24 outpatients and 4 inpatients. Payments made by three insurance companies for overseas medical institution services for Japanese tourists with pharyngitis were analyzed. This study shows that the appropriate medical treatment prices for FVs, considering profits, were 1.22–4.26 times higher compared with prices under Japan’s public health insurance plans. Furthermore, these prices were 1.31–4.26 times higher for outpatients with pharyngitis and external injury and 1.22–3.66 times higher for inpatients with appendicitis and femoral fractures. The price of pharyngitis treatment in 12 countries was USD 20.32–158.75 per patient for Japanese tourists, whereas FVs paid 60.24 dollars (1.13 times higher than Japan’s public healthcare price) in Japan. This study shows it was appropriate to set the ideal price level for FVs higher than that for Japanese patients.

scholarly journals Evaluation of the nature and etiologies of risk factors for diaphyseal atypical femoral fractures

2021 ◽  
Author(s):  
Hiroyuki Tsuchie ◽  
Naohisa Miyakoshi ◽  
Yuji Kasukawa ◽  
Koji Nozaka ◽  
Kimio Saito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analyses ◽  
Femoral Fractures ◽  
Japanese Patients ◽  
High Serum ◽  
Control Group ◽  
Atypical Femoral Fractures ◽  
Factors Affecting ◽  
Lateral Curvature ◽  
Low Serum

Objectives: Differences in the mechanisms of subtrochanteric and diaphyseal atypical femoral fractures (AFFs) have been speculated in studies that have analyzed differences in the patients’ backgrounds. However, the etiologies of each type of AFF have not been investigated in detail. Therefore, this study aimed to investigate the nature and etiologies of the risk factors for diaphyseal AFFs. Materials and Methods: Eighty consecutive Japanese patients with 91 diaphyseal AFFs (the AFF group) and 110 age-matched female patients with osteoporosis (the non-AFF control group) were included. Their clinical data were compared and the factors affecting AFFs were investigated. Furthermore, the etiologies of the risk factors for diaphyseal AFFs were examined. Results: Multivariate analysis revealed that femoral serrated changes, bisphosphonate or denosumab usage, and lateral and anterior femoral curvatures were the risk factors for diaphyseal AFFs (p<0.0011, p=0.0137, and p<0.0001, respectively). Multivariate analyses also revealed that serrated changes and low serum 25(OH)D levels affected the lateral curvature (p=0.0088 and 0.0205, respectively), while serrated changes affected the anterior curvature (p=0.0006); each significantly affected the femoral curvature. In addition, a high serum calcium (Ca) level, lateral femoral curvature, and anterior femoral curvature were the predictors of serrated changes (p=0.0146, 0.0002, and 0.0098, respectively). Conclusion: The risk factors for diaphyseal AFFs were bone resorption inhibitor usage, a strong femoral curvature, and serrated changes. A low serum 25(OH)D level and serrated changes are the risk factors for lateral curvature, while a high serum Ca level is a risk factor for serrated changes.

scholarly journals Prognosis of Medical Treatment for Japanese Patients with Carotid Stenosis

2011 ◽  
Vol 50 (4) ◽  
pp. 291-296 ◽  
Author(s):  
Toshiyasu Ogata ◽  
Masahiro Yasaka ◽  
Yoshiyuki Wakugawa ◽  
Kotaro Yasumori ◽  
Takanari Kitazono ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Carotid Stenosis ◽  
Japanese Patients

Efficiency Evaluation of European Countries in terms of COVID-19 (Preprint)

2020 ◽  
Author(s):  
Gökçen Bayram ◽  
Özlem Yurtsever
Keyword(s):  
Medical Treatment ◽  
High Performance ◽  
Poor Performance ◽  
European Countries ◽  
Critical Conditions ◽  
Data Envelopment ◽  
Treatment Efficiency ◽  
Control Efficiency ◽  
Second Stage ◽  
Two Stages

BACKGROUND The COVID-19 Pandemic has effected millions of people all over the world. Therefore the behaviour of countries are important to minimise the losses. OBJECTIVE The aim of this study is to evaluate and compare the performance of 27 European Countries on spread and deaths caused by COVID-19 pandemics by using input-oriented data envelopment analysis (DEA) method. A comparison was done between the 27 European Countries for contagion control efficiency and medical treatment efficiency. METHODS The DEA model is performed in two stages. In the first stage, the contagion control efficiency is analysed whereas in the second stage the medical treatment efficiency is evaluated. Moreover, the countries are classified into the four zone by using the area chart. For the countries in each zones, some recommendations are given. RESULTS Luxembourg has a poor performance in contagion control. In addition, Denmark and Iceland have a good performance in medical treatment of COVID-19 patients in comparison to other countries in the study. Malta, Montenegro, Cyprus, Denmark, Estonia, Finland, Greece, Netherlands and Norway are in Area 1, showing that these countries have been acted efficiently both in contagion control and medical treatment of the patients. Italy, Spain, Iceland and Portugal are in Area 2. These countries have had good performance in medical treatment but they have had controlled the contagion inefficiently. The countries which have been acted inefficiently both in contagion control and medical treatment of the patients are in Area 3. Luxembourg, North Macedonia, Switzerland and Turkey are in critical conditions in this manner. Lastly, Poland, Romania, Slovakia, Austria, Bulgaria, Czechia, Hungary, France, Germany and Croatia are in Area 4. These countries have been successful in providing a good performance in contagion control but they have had poor performance in medical treatment. CONCLUSIONS The countries are classified in to the four zones according to their performance. Countries in Area 1 has a high performance in both contagion control and medical treatment. All the other countries should follow the footprints of the countries in Area 1. In addition, Luxembourg, North Macedonia, Switzerland and Turkey are in critical conditions and need a special attention.

Performance-based salary distribution ratio in clinical departments of public hospitals based on improved DEA method

2021 ◽  
pp. 1-9
Author(s):  
Lei Wang ◽  
Rongjing Huang ◽  
Shuai Ding ◽  
Guofu Li ◽  
Shaohua Wang ◽  
...  
Keyword(s):  
Empirical Analysis ◽  
Distribution System ◽  
Public Hospital ◽  
Hospital Staff ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Hospital Management System ◽  
Two Stages ◽  
Clinical Departments ◽  
Salary Distribution

Performance-based salary distribution is one of the important contents of modern hospital management system. In general, the distribution of performance salary in public hospitals of China can be divided into two stages: one is from hospitals to departments, the other is from departments to individuals. It is of great significance to improve the performance-based salary distribution system in clinical departments of public hospital, which is beneficial to ensure the public nature, motivate hospital staff to work hard, and raise public healthcare service quality. Therefore, this paper focuses on the issue of performance-based salary distribution in clinical departments of public hospital, adopts super-efficiency DEA model to evaluate the performance of each clinical department, introduces a new utility function for processing the original values of DEA efficient DMUs in order to encourage more clinical departments to pursue higher performance, and finally verifies the comprehensive model by empirical analysis. The result of empirical analysis shows that the performance of DMU7 is highest with an efficiency value of 1.53, followed by DMU3, DMU8, and DMU1. The efficiency value of DMU9 is lowest in all clinical departments.

Surgical treatment of Vancouver type B periprosthetic femoral fractures

2019 ◽  
Vol 101-B (11) ◽  
pp. 1447-1458 ◽  
Author(s):  
Georgios Chatziagorou ◽  
Hans Lindahl ◽  
Johan Kärrholm
Keyword(s):  
Plate Osteosynthesis ◽  
Femoral Fractures ◽  
Patient Characteristics ◽  
Primary Outcome Measure ◽  
Periprosthetic Femoral Fracture ◽  
Type B ◽  
National Patient ◽  
Component Revision ◽  
Two Stages ◽  
Hip Arthroplasties

Aims We investigated patient characteristics and outcomes of Vancouver type B periprosthetic fractures treated with femoral component revision and/or osteosynthesis. Patients and Methods The study utilized data from the Swedish Hip Arthroplasty Register (SHAR) and information from patient records. We included all primary total hip arthroplasties (THAs) performed in Sweden since 1979, and undergoing further surgery due to Vancouver type B periprosthetic femoral fracture between 2001 and 2011. The primary outcome measure was any further reoperation between 2001 and 2013. Cross-referencing with the National Patient Register was performed in two stages, in order to identify all surgical procedures not recorded on the SHAR. Results Out of 1381 Vancouver type B fractures that fulfilled the inclusion criteria, 257 underwent further reoperation by the end of 2013. Interprosthetic and Type B1 fractures had a higher risk for reoperation. For B1 fractures, the rate of reoperation did not differ (p = 0.322) after use of conventional (26%) or locking plate osteosynthesis (19%). No significant differences were observed between cemented, cementless monoblock, and cementless modular revision components for the treatment of type B2 and B3 fractures. Conclusion In this country-specific study, the choice of locking or conventional plates for the treatment of type B1, and cemented or cementless femoral components fixation for B2 and B3 fractures, had no significant influence on risk for reoperation. Interprosthetic fractures adversely affected the outcome of treatment of type B fractures. Differences in the patient characteristics of the compared groups were observed. Cite this article: Bone Joint J 2019;101-B:1447–1458.

Autonomous Decision Making and Japanese Tradition

1995 ◽  
Vol 4 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Kazumasa Hoshino
Keyword(s):  
Decision Making ◽  
Medical Treatment ◽  
Family Members ◽  
Japanese Patients ◽  
Self Determination ◽  
Legal Obligation ◽  
Healthcare Decision ◽  
Autonomous Decision ◽  
Healthcare Decision Making

Crucial problems exist in understanding Japanese traditional customs with regard to autonomous decision making by patients in Japan. These problems are difficult to comprehend because they seem, by western standards, to defy logic. Questions that baffle those outside the Japanese tradition, include: Why do many Japanese patients hesitate to make medical treatment and care decisions for themselves without consulting family, close friends, or someone viewed as being in a superior position? Why do many Japanese physicians fail to disclose the truth directly to the patient, instead customarily conveying information to family members, despite the doctors' awareness of their legal obligation to protect the patient's privacy? Why do many Japanese physicians continue to question whether patients should be told the truth at all? What perpetuates Japan's widespread, but often unnoticed, neglect of the individual's right to self-determination in healthcare decision making?

scholarly journals The shared learning journey: effective partnerships to deliver health promotion

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Larissa Elisabeth Kempenaar ◽  
Sivaramkumar Shanmugam
Keyword(s):  
Health Promotion ◽  
Academic Staff ◽  
Public Healthcare ◽  
Community Partners ◽  
Shared Learning ◽  
The Public ◽  
Learning Journey ◽  
Effective Delivery ◽  
Promotion Strategies ◽  
Two Stages

Health promotion is a key role for healthcare professionals. It is based on effective collaboration between the healthcare professional and the public. Healthcare education has the challenge of future-proofing its curricula to meet the challenges laid out in health promotion strategies. However, engaging students in health promotion has traditionally been challenging within the delivery of an academic and largely theoretical module.This paper provides a practice example of an initiative in which partnerships between students, academic staff and community partners are key to the effective delivery of a health promotion module within a pre-registration healthcare programme.The partnerships were developed in two stages and use a social constructivist and assets-based approach to create a shared learning journey. Working in partnership has led to positive student engagement and has been beneficial to all those involved. It has led to positive changes within the module and beyond.  

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