Future of Japan's system of good health at low cost with equity: beyond universal coverage

Shibuya, Kenji; Hashimoto, Hideki; Ikegami, Naoki; Nishi, Akihiro; Tanimoto, Tetsuya; Matsubara, Hiroaki; Takemi, Keizo; Reich, Michael R.

doi:10.1016/s0140-6736(11)61098-2

Cited by 122 publications

(111 citation statements)

References 28 publications

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“…Therefore, Japanese people can access treatment more easily than people in many other countries, and at a lower cost 26) . This may make comparisons with previous studies difficult, especially concerning the definition of POAs.…”

Section: Discussionmentioning

confidence: 99%

Tooth Loss in Problem-oriented, Irregular, and Regular Attenders at Dental Offices

Yoshino

Itō²,

Kuroda³

et al. 2016

Bull. Tokyo Dent. Coll.

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The aim of this retrospective study was to compare number of teeth lost among regular attenders (RAs), irregular attenders (IRAs), and problem-oriented attenders (POAs) at dental offices over a 10-yr observation period. Information on tooth loss was obtained from general practitioners. Patients were divided into 3 groups based on appointment adherence. A total of 1,886 teeth were lost in 1,400 patients. The mean number of teeth lost in men was 2.2±2.6 per patient over 10 yr in POAs, 1.2±1.7 in IRAs, and 1.5±1.5 in RAs. This number was significantly lower in IRAs (p=0.011) or RAs (p=0.012) than in POAs. When the dependent variable was defined as "a patient with at least 2 or more extracted teeth", the independent variables showed the following correlations with tooth loss: IRAs (OR: 0.54; 95%CI: 0.35-0.84), RAs (OR: 0.65; 95%CI: 0.47-0.89), man (OR: 1.43; 95%CI: 1.11-1.83), hypertension (OR: 1.38; 95%CI: 1.04-1.85), 20-25 present teeth (OR: 2.41; 95%CI: 1.81-3.22), and 1-19 present teeth (OR: 3.75; 95%CI: 2.73-5.16). The risk of tooth loss showed a 0.65-fold increase in RAs undergoing maintenance compared with POAs. Motivating patients to visit the dentist more regularly and undergo maintenance is important. The present results may be of use to dental professionals in providing patients with detailed information on potential tooth loss and associated risk factors with the aim of achieving such a change in behavior.

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Section: Discussionmentioning

confidence: 99%

Tooth Loss in Problem-oriented, Irregular, and Regular Attenders at Dental Offices

Yoshino

Itō²,

Kuroda³

et al. 2016

Bull. Tokyo Dent. Coll.

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“…F our years ago, Japan celebrated 50 years of achievement of good health at low cost and increasing equity for its population. 1 In 1961, at the beginning of a period of rapid economic development, while for Japanese men surpassed 80 years in 2013. Japan's infant mortality rate, reported as 2.1 per 1000 live births in 2013, is the lowest in the world.…”

Section: International Health C Are Sys Temsmentioning

confidence: 99%

“…Under the current system of insurance, many patients have to pay large sums out of pocket, and research shows that when that happens, some patients will stop taking medications even if they are very effective. 1 The high costs of cancer care also drive patients into bankruptcy.…”

mentioning

confidence: 99%

The Future of Japan's Health System — Sustaining Good Health with Equity at Low Cost

Reich

Shibuya

2015

N Engl J Med

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“…Given Japan's rapidly aging population and continuous budget deficits, there is no doubt that the current health care system faces significant challenges (17,18). Without substantial reform, the system's sustainability will be called into question.…”

Section: Prospects For the Futurementioning

confidence: 99%

Japan's advanced medicine

2013

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Future of Japan's system of good health at low cost with equity: beyond universal coverage

Cited by 122 publications

References 28 publications

Tooth Loss in Problem-oriented, Irregular, and Regular Attenders at Dental Offices

Tooth Loss in Problem-oriented, Irregular, and Regular Attenders at Dental Offices

The Future of Japan's Health System — Sustaining Good Health with Equity at Low Cost

Japan's advanced medicine

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