1年生 基礎セミナー 2019年10月28日

Universal Health Coverage
その実現
全ての人が適切な予防、治療、リハビリ等の保健医療サービスを、必要な時に支払い可能な費用で受けられる状態

Health Services
Consumers (patients)

Government

Disease pattern
ProvidersRegulation
Subsidiary

Facilities
Professionals
Content of services / Technology

Financing / InsuranceConsumers (patients)

Disease patter
https://www.koukankai.or.jp/site_data/nihonkoukan/files/fureai39.pdf 2020/10/20

What are the main killers in the regions ?
How large is the impact of the disease ?
Who are vulnerable ?
https://youtu.be/OweW7PChU1g 2020/10/20

https://www.hokusetsu-hp.jp/shinryo/06.html 2020/10/20

http://slideshowjp.com/doc/41863/slide-8 2020/10/20

https://www.premierdentalanesthesiology.net/ 2020/11/19

https://www.town.bandai.fukushima.jp/soshik
i/rurinosato/tayori_0908i.html 2020/11/19

https://www.saludalia.com/psicologia/lasherramientas-del-psicologo
2020/11/19

https://nurse.dept.showa.gunmau.ac.jp/blog/?m=201005 2020/11/19

Providers

Facilities
Professionals

http://www.yashimahp.com/sp_10.html 2020/11/19

Roles
Appropriate number
Distribution
Education
Evaluation

Content of services / Technology

Repo men（2010）Miguel Rosenberg-Sapochnik Relativity Media

http://hiyoshi-hp.com/wpcontent/uploads/anataniattaoj
usuriwo.pdf 2021/1/13

https://www.kango-roo.com/ki/image_386/ 2021/1/20©︎pixabay

Health Services
Government
regulation

Consumers (patients)

Disease patter
Providers

Facilities
Professionals
Content of services / Technology

Financing / Insurance
https://www.photolibrary.jp/img3/343_4960.html 2020/12/16

Japan’s strategy for
global health diplomacy:
why it matters
Lancet 2013; 382: 915-6. September 14.

https://japan.kantei.go.jp/96_abe/statement/201309/17lancet_e.html
2020/12/16Strategy on Global Health Diplomacy
Universal health coverage with three goals
1. to improve the health of entire populations,
2. to ensure health service provision for all people, shiftingfrom a disease-oriented to a people-oriented approach,and
3. to enable to implement health policies that fill diversified
needs with a limited budget.
Global Health Innovative Technology Fund in April 2013.

Universal Health Coverage (UHC)

UHC in Japan①Those under public assistance (2.2 mil in 2015)②Elderly aged >75 years with a limited income③Children before elementary school④Elderly aged 70-74 years
with a limited income⑤Elderly age >70 years
with a similar income to ⑥
(taxable income >1.45 mil andtotal income >3.85 min insingle family househould or>5.2 min in 2 generation
household⑥The others under healthinsurance⑦Those without support

100%
90%
80%
70%

#
# Free services such as
infection treatments⑦⑥⑤ ④③Health insurance②①Services
coveredPublic assistanceWorｌd War II

Lancet 2011; 378: 1106-15

Japan

8.3%(2012)

Drivers of UHC in China(1) The SARS outbreak as a wake-up call(2) Strong public support for governmental
intervention in health care(3) Renewed political commitment from top leaders(4) Heavy government subsidies(5) Fiscal capacity backed by China’s economicpower(6) Financial and political responsibilities deligated tolocal governments: Not achieving the targets
would lead to poor scores for the performance
evaluation of local officials(7) Programmatic implementation strategy: wide but
shallow coverageChina in 2011
OOP
35%
GGHE
56%
The others 9%

Regional Office for the Western Pacific. Regional Committee.
Universal Health Coverage. WPR/RC66/6, 7 September 2015

Regional Office for the Western Pacific. Regional Committee.
Universal Health Coverage. WPR/RC66/6, 7 September 2015

Trends in life expectancy at birth, 1900-2008
MaleJapanFemale

JapanAmong the elevation of life
expectancy in the 60 years
1950-2010, 40% wasachieved during 1950-1965:
10.1 years in men and 11.9
years in women

The reasons:
1. Hygiene 2. Health consciousness 3. Balanced food
Education, Economic growth, and health services
Lancet 2011; 378: 1094-105

http://www.phk.jp/author/i-pocket13/ 2020/12/16©︎pixabay

http://takigyou.jp/ 2021/1/18

Huge amountof clean water

Trends in life expectancy at birth, 1900-2008
MaleJapan

FemaleJapan

Among the elevation of life
expectancy in the 60 years
1950-2010, 40% wasachieved during 1950-1965:
10.1 years in men and 11.9
years in women

The reasons:Lancet 2011; 378: 1094-105