Tajimi K, Shimada Y, Nishimura S, Sirio C A
Trauma and Critical Care Center, Teikyo University School of Medicine, Tokyo, Japan.
New Horiz. 1994 Aug;2(3):404-12.
The Japanese healthcare system is structured to provide universal healthcare access to the entire Japanese population via a constitutional guarantee. Increasing costs within the Japanese healthcare system are largely attributable to the country's rapidly aging population. Intensive care services are provided primarily in large tertiary care hospitals by a relatively small cadre of dedicated critical care physicians. Triage pressure is high in many Japanese hospitals due to a relatively small proportion of ICU beds. As a result, few patients are admitted to the ICU at low risk of adverse outcome or monitoring. Costs associated with providing critical care are poorly understood because of current hospital cost accounting systems. Critical care costs have only recently become an area of concern. Nevertheless, critical care physicians are taking steps to more fully understand severity of illness, clinical outcome, and utilization of resources in order to effectively guide healthcare policy and resource allocation decisions impacting Japanese critical care.
日本的医疗保健系统旨在通过宪法保障为全体日本民众提供全民医疗保健服务。日本医疗保健系统成本不断增加，这在很大程度上归因于该国迅速老龄化的人口。重症监护服务主要由相对少数的专业重症监护医生在大型三级医疗机构中提供。由于重症监护病房床位比例相对较小，许多日本医院的分诊压力很大。因此，很少有不良结局或监测风险较低的患者被收入重症监护病房。由于当前的医院成本核算系统，提供重症监护的相关成本尚不清楚。重症监护成本直到最近才成为一个受关注的领域。尽管如此，重症监护医生正在采取措施，以更全面地了解疾病严重程度、临床结局和资源利用情况，从而有效地指导影响日本重症监护的医疗政策和资源分配决策。
