Yoshio Mitsumori02.27.07
According to the national surveillance study conducted by the Ministry of Health, Labor and Welfare (MHLW), the estimated number of patients who received medical care at a medical institution as of October 2006 was 1,463,000 for those who were admitted as patients and 7,092,000 for those who were treated as outpatients. Looking back at past records, the number of admitted patients increased until 1990 but then decreased from 2003 onward—and this downward trend is still occurring.
Among the 7,092,000 outpatients, 1,866,000 (26.3%) visited a hospital, 3,949,000 (55.7%) visited a clinic and 1,277,000 (18.0%) visited a dental clinic. The overall number of outpatient visitors to hospitals has decreased since 1999, but the amount of patients who have utilized clinic services has increased.
In the past, many patients, particularly the elderly, opted to receive care from an acute-care hospital instead of a clinic—even for minor disease—but data now show patients are visiting clinics instead. The referral system, in which patients are sent from a clinic to a large hospital, apparently gradually has changed the patient mindset and led many to visit a clinic first. This trend actually was a goal of the government, and it appears to be working to the government’s favor.
Within these facilities, the number of orthopedic, cardiology, neurology and respiratory units has increased while the amount of pediatric, obstetric/gynecologic and general surgery units has decreased. One reason for the latter development is that the tough working conditions for those specialty units has made some young physicians shy away from those specialties. Consequently, the shortage of specialized physicians in pediatrics and obstetrics/gynecology is becoming a serious social problem in Japan.