The WHO Kobe Centre (WKC) organized the WKC Forum "Japan to the world- Achieving sustainable UHC for older people" in cooperation with the 72nd Annual Meeting of Japanese Society of National Medical Services on November 10th, 2018, at the Kobe International Conference Centre Main Hall.
At the Forum, researchers presented three studies being conducted as a part of the WHO Kobe Centre New Research Initiative: Lessons Learned from Japan to the World, based on a WKC call for proposals in 2017.
Dr Misato Nihei, a lecturer at the Graduate School of Frontier Sciences at The University of Tokyo, gave a presentation on “Experiences of Assistive Products Use among Older People in Japan”.
“There are currently around 70,000 centenarians in Japan’s aging society,” Dr Nihei explained. “The use of assistive products, which include assistive technology and equipment, is essential for older people to not only overcome obstacles in their environment but also to live more comfortably at home and remain active and engaged members of society. It is possible for older people to use a wide range of assistive products available under long term care insurance, for example, wheelchairs, beds, walkers, canes, handrails and slopes. There has also been a recent surge in the development of robotic assistive technology for caregiving.”
A questionnaire done in Itami City showed that people who use assistive products most commonly use five different products at the same time. Also, as people grow older, they use devices to assist with sitting and sleeping. Using dentures, eyeglasses and handrails is particularly common. The survey also revealed that only around 2% of respondents did not use any assistive products. The researchers will carry out interviews during the next stage of the study.
Dr Shinichi Tomioka, Assistant Professor at the Department of Preventive Medicine and Community Health at the University of Occupational and Environmental Health (UOEH), gave a presentation on “Evidence for improving health care provision to ensure universal health coverage amid rapid population ageing in Japan.”
“Large-scale administrative data are still relatively underutilized in health research in Japan,” Dr Tomioka said. “For instance, the medical fee reimbursement database covers an enormous number of patients, and provides accurate information on the administered treatments, prescription medication, medical fees and other items. We are now able to extract the information we require from this large-scale administrative data, and use it to establish a large amount of multifaceted evidence.”
This research analyses data among patients that used outpatient care, home care, disaster health care, and acute hospital care. The analysis of data on 16,000 outpatients found that an individual visits three different facilities for outpatient care annually on average. The most common diseases treated are high blood pressure, hyperlipidemia and gastritis. Analysing medical fees revealed that 30% of patients account for over 70% of the fees, with dialysis for renal failure and anti-cancer medicines being the costliest items.
For disaster health care, the researchers developed a new mobile application J-SPEED+ (Japanese Surveillance in Post-Extreme Emergencies and Disasters). Information on the location, condition and number of patients in disaster-affected areas is entered into the system using a smart phone; this information can then be immediately tallied and viewed at the Disaster Management Headquarters. J-SPEED+ is designed to make disaster health care data more visible.
Dr Takako Tsutsui, Professor in the Department of Public Health at the University of Hyogo gave a presentation on “ICF (International Classification of Functioning, Disability and Health)-based assessment tool development for care skill training in the Japanese long-term care system.”
Dr Tsutsui explained, “It is becoming increasingly difficult to secure long-term care workers to look after the growing number of old people, and there is already a perpetual lack of workers in the industry. The most pressing issue at present is developing ways to maintain the existing long-term care workforce, and also attract new workers by making long-term care a more viable and rewarding career path.”
Since Japan’s long-term care is well established, long-term care has been added as a component of the government’s Technical Intern Training Programme. This new programme is for foreign trainees who wish to work in the long-term care field. This study used the WHO’s International Classification of Functioning, Disability and Health (ICF) framework to objectively evaluate whether the trainees have acquired the necessary level of technical skills and techniques through the programme. The study found that while the items in the evaluation tool are useful, there are several tasks that require Japanese language and cultural competency.