| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
PERITONEAL DIALYSIS IN JAPAN |
Suzuka University of Medical Science, Suzuka, and Naito Medical Research Institute, Kobe, Japan
Correspondence to: H. Naito, 302 Shinkobe Building, 1-4-20, Ikuta-cho,
Chuo-ku, Kobe 651-0092
Japan.
naito{at}kh.rim.or.jp
Like most countries, Japan is facing constraints on expansion of health
system financial resources. There are almost 250 000 Japanese patients with
end-stage renal disease and almost all are managed by chronic dialysis.
Hospital hemodialysis is the modality used by 96% of these patients.
The Japanese health-care system has tended to support resource-intensive
treatments because the fee-for-service remuneration system has rewarded their
utilization. This has benefited hemodialysis at the expense of peritoneal
dialysis. However, this may now be changing. Case management and global
budget-related approaches are being more widely introduced, as are incentives
to reward more efficient treatment options. The relative costs of dialysis
modalities are difficult to appreciate, as center-based services, such as
hospital hemodialysis, are dependent upon fixed resources, while home-based
options, such as peritoneal dialysis, are dependent upon variable
resources.
The aim of this review is to reconcile various sources of information
relevant to end-stage renal disease funding in Japan. The review will suggest
that modifying the approach to modality selection could lead to more efficient
allocation of future dialysis-related resources and so reduce the strain on
Japan's health-care budget.
KEY WORDS: Hemodialysis; end-stage renal disease; health-care system; reimbursement; health-care expenditure; health-care economics.
Received 27 October 2005; accepted 31 January 2006.
This article has been cited by other articles:
|
|
 |
|
  W.-C. Yang, S.-J. Hwang, and Taiwan Society of Nephrology Incidence, prevalence and mortality trends of dialysis end-stage renal disease in Taiwan from 1990 to 2001: the impact of national health insurance Nephrol. Dial. Transplant., December 1, 2008; 23(12): 3977 - 3982. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Fukagawa Nephrology in Earthquakes: Sharing Experiences and Information Clin. J. Am. Soc. Nephrol., July 1, 2007; 2(4): 803 - 808. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
 |
