Hitotsubashi University, Asian Public Policy Program, School of International and Public Policy, 2-1-2, Hitotsubashi, Chiyoda-ku, Tokyo 101-8439, Japan.
Osaka Prefecture University, Graduate School of Economics, 1-1, Gakuen-cho, Naka-ku, Sakai-shi, Osaka 599-8531, Japan.
Health Policy. 2019 Apr;123(4):345-352. doi: 10.1016/j.healthpol.2018.11.008. Epub 2018 Nov 28.
Japan's universal health care system provides many advantages for its users, including affordable health coverage with free and equal access to medical institutions. However, the Japanese population's satisfaction with the health care system is among the lowest internationally. This paper investigates the extent and determinants of satisfaction toward Japan's health care system and services, and compares the results with those of eleven other high-income countries.
We collected data from Japanese respondents of a 2014 survey based on the 2010 Commonwealth Fund International Health Policy Survey. We analyzed survey data to explore the determinants of the respondents' overall satisfaction with the health care system, and quantified satisfaction using various dimensions.
Almost 17% of respondents were "not sure" of their opinion of Japan's health care system. Overall satisfaction in Japan was much lower than that of other high-income countries. Older respondents (≥65 y) evaluated the system more than twice as favorably as younger respondents. Also, the respondents' overall satisfaction with the health care system was intrinsically related to their assessments of health services actually received.
The higher satisfaction of older persons may be influenced by their higher care needs and use of health services than younger respondents. The promotion of community-based preventive services involving well-trained professionals may improve the use of health care and increase satisfaction levels.
日本的全民医保体系为其用户提供了诸多优势，包括负担得起的医疗保险，以及可自由平等地获得医疗机构服务。然而，日本民众对其医疗体系的满意度在国际上处于较低水平。本文旨在调查日本民众对其医疗体系和服务的满意度程度及其决定因素，并将结果与其他 11 个高收入国家进行比较。
我们收集了 2014 年基于 2010 年英联邦基金国际卫生政策调查的日本受访者的数据。我们分析了调查数据，以探索影响受访者对医疗体系整体满意度的决定因素，并使用各种维度来量化满意度。
近 17%的受访者对日本的医疗体系“不确定”。日本民众的整体满意度远低于其他高收入国家。年龄较大的受访者（≥65 岁）对体系的评价比年轻受访者高出两倍多。此外，受访者对医疗体系的整体满意度与其对实际获得的医疗服务的评估有着内在的关系。
老年人的满意度较高可能受到其对医疗服务的需求和使用高于年轻受访者的影响。推广涉及训练有素的专业人员的社区基础预防服务可能会提高医疗保健的使用并增加满意度。
