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Integrated care through disease-oriented critical paths:experience from Japan’s regional health planning initiatives

Authors:

Etsuji Okamoto ,

National Institute of Public Health, JP
About Etsuji
Prod. Dr., National Institute of Public Health, Department of Management Sciences, Japan
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Masaki Miyamoto,

JP
About Masaki

Hyogo Medical College, Department of Medical Informatics, 1-1 Mukogawa-cho, Nishinomiya-shi, Hyogo 663-8501, Japan

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Kazuhiro Hara,

JP
About Kazuhiro

Kagawa University, Seto Inland Sea Regional Research Center, Saiwaicho 1-1, Takamatsu City,Kagawa 760-8521, Japan

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Jun Yoshida,

JP
About Jun

Japan Labour Health and Welfare Organization CHUBU-ROSAI Hospital, 1-10-6 Komei, Minato-ku,Nagoya-shi, Aichi 455-8530, Japan

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Masaki Muto,

About Masaki

International Health and Welfare University Graduate School, 1-3-3 Minami-Aoyama, Minato-ku,Tokyo 107-0062, Japan

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Aizan Hirai,

JP
About Aizan

Chiba Prefectural Togane Hospital, 1229 Daiho, Togane-shi, Chiba 283-8588, Japan

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Haruyuki Tatsumi,

JP
About Haruyuki

Sapporo Medical School, Department of Anatomy, Minami-1-jo, Nishi-17-chome, Chuo-ku, Sapporo-shi,Hokkaido 060-8556, Japan

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Masaaki Mizuno,

JP
About Masaaki

Nagoya University Hospital Center for Advanced Medicine and Clinical Research, 65 Tsurumai, Showa-ku, Nagoya-shi, Aichi 466-8560, Japan

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Hiroshi Nagata,

JP
About Hiroshi

Nagahama Bio University, Department of Computer Bioscience, 1266 Tamura-machi, Nagahama-shi, Shiga 526-0829, Japan

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Daisuke Yamakata,

JP
About Daisuke

Kagawa University, Department of Medical Information, 1750-1 Ikedo, Miki-cho, Kida-gun, Kagawa 761-0793, Japan

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Hiroshi Tanaka

JP
About Hiroshi

Tokyo Medical and Dental University, Department of Bioinformatics, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Abstract

Introduction: In April 2008, Japan launched a radical reform in regional health planning that emphasized the development of disease-oriented clinical care pathways. These 'inter-provider critical paths' have sought to ensure effective integration of various providers ranging among primary care practitioners, acute care hospitals, rehabilitation hospitals, long-term care facilities and home care.  

Description of policy practice: All 47 prefectures in Japan developed their Regional Health Plans pursuant to the guideline requiring that these should include at least four diseases: diabetes, acute myocardial infarction, cerebrovascular accident and cancer.  To illustrate the care pathways developed, this paper describes the guideline referring to strokes and provides examples of the new Regional Health Plans as well as examples of disease-oriented inter-provider clinical paths. In particular, the paper examines the development of information sharing through electronic health records (EHR) to enhance effective integration among providers is discussed.

Discussion and conclusion: Japan's reform in 2008 is unique in that the concept of "disease-oriented regional inter-provider critical paths" was adopted as a national policy and all 47 prefectures developed their Regional Health Plans simultaneously. How much the new regional health planning policy has improved the quality and outcome of care remains to be seen and will be evaluated in 2013 after the five year planned period of implementation has concluded. Whilst electronic health records appear to be a useful tool in supporting care integration they do not guarantee success in the application of an inter-provider critical path.

How to Cite: Okamoto E, Miyamoto M, Hara K, Yoshida J, Muto M, Hirai A, et al.. Integrated care through disease-oriented critical paths:experience from Japan’s regional health planning initiatives. International Journal of Integrated Care. 2011;11(5):None. DOI: http://doi.org/10.5334/ijic.561
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Published on 23 Sep 2011.
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