Search Results (31)

Background/Objectives: Unpaid medical expenses incurred by foreign nationals represent a growing concern for healthcare systems amid increasing international mobility. Japan, which lacks mandatory public insurance coverage for non-resident visitors, faces particular vulnerability in terms of uncompensated hospital care. This study aims to identify factors contributing to unpaid medical charges among uninsured, non-resident foreign patients hospitalized at a tertiary care facility in Tokyo. Methods: This retrospective observational analysis was conducted using medical and administrative data from patients admitted between January 2023 and February 2025. Patients who received elective medical tourism care were excluded. Data on demographics, length of hospital stay, care intensity, payment status, and third-party financial assistance were analyzed. Logistic regression models were applied to assess predictors of nonpayment. Results: Among 153 eligible cases, 9 patients (5.9%) had outstanding hospital bills upon discharge. Compared with those with completed payments, the unpaid group experienced longer admissions, more intensive care utilization, and higher total charges. Notably, the absence of third-party financial support (primarily travel insurance) was significantly associated with unpaid charges. Multivariate analysis identified this factor as the main independent predictor (adjusted odds ratio [OR]: 0.12; 95% confidence interval [CI]: 0.02–0.915; p = 0.040). Total amount of billing was also statistically significant (adjusted odds ratio [OR]: 1.01; 95% confidence interval [CI]: 1.00–1.01; p = 0.039). Conclusions: These findings highlight the importance of private insurance in mitigating financial risk in hospitals. Implementing policy measures to promote or require insurance enrollment, along with streamlined reimbursement systems, may contribute to sustainable care delivery for international patients. Full article

This study compares certification systems for green healthcare facilities implemented worldwide. Healthcare facilities are complex structures designed to provide uninterrupted service while involving substantial resources, high energy consumption, and heavy human and material traffic. The COVID-19 pandemic emphasized the importance of designs that ensure hygiene, reduce environmental impact, and improve energy efficiency, making green certification systems for healthcare facilities increasingly critical. Eight certification systems currently in use across eight countries were examined, four from advanced economies (LEED in the U.S., BREEAM in the U.K., Green Star in Australia, and CASBEE in Japan) and four from developing economies (YeS-TR in Türkiye, IGBC in India, GBI in Malaysia, and GREENSHIP in Indonesia). Country selection considered regional diversity, similarities in environmental policies, and the potential for healthcare infrastructure development. A literature-based comparative analysis was conducted, and seven key categories were identified for evaluating sustainability: sustainable land and transport, water and waste management, energy efficiency, material and life cycle impact, indoor environmental quality, project management process, and innovation. The comparison revealed considerable overlap among the systems but also highlighted shortcomings in addressing healthcare-specific needs. This paper contributes to the advancement of sustainability assessment in the healthcare sector by highlighting the need for certification schemes specifically designed for medical facilities. The findings emphasize the necessity of developing healthcare-tailored frameworks that not only address environmental performance but also capture the unique operational, functional, and clinical dynamics of this sector. Full article

Evaluation of an individual’s accessibility to urban services is crucial for urban planners and policymakers to assess various urban policies and scenarios. Most studies have emphasized accessibility in physical spaces, with limited attention to the role of Information and Communication Technology (ICT) in providing virtual access and its implications for quality of life (QOL) and sustainability. This study addresses this gap by examining the substitutability of physical activities with digital alternatives and their potential contribution to decarbonization. Using data from an online questionnaire survey in Japan, we analyze how individuals access services across both transportation and ICT networks. We propose an integrated evaluation framework that measures QOL by considering accessibility in both physical and virtual spaces. The analysis highlights differences in substitutability across activities such as shopping, working, schooling, and entertainment, while revealing that services like healthcare and physical tourism remain less substitutable. The results disclose that accessibility strongly influences individuals’ adoption of digital alternatives, which in turn offer significant benefits in terms of convenience and environmental impact. The proposed methodology provides valuable insights seeking to balance physical and virtual service accessibility, supporting sustainable urban development in line with UN Sustainable Development Goals 10 and 11. Full article

Japanese Encephalitis (JE) is a mosquito-borne viral infection that causes acute brain inflammation. First identified in Japan in 1871, the disease gained renewed global attention in 2025 after emerging in a non-endemic region, raising significant healthcare concerns. Vaccination remains the most effective strategy for preventing outbreaks. However, low- and middle-income countries (LMICs) face considerable challenges in implementing vaccination programs due to geographical, economic, and regulatory barriers. Most existing studies on JE vaccines (JEVs) have been conducted in higher-income countries, leaving critical gaps in data on efficacy and safety in LMIC settings. Furthermore, uncertainties surrounding cost-effectiveness make funding decisions more complex. This narrative review evaluates the current evidence on JE vaccination in LMICs, based on a literature search in PubMed and ScienceDirect covering 2005–2025. The review examines vaccine efficacy, safety, cost-effectiveness, and policy implementation. Findings show that JEVs demonstrate high efficacy and strong safety profiles, with mild adverse effects, most commonly fever. The live attenuated SA 14-14-2 vaccine (LAJEV) is particularly cost-effective, offering substantial economic benefits by reducing healthcare expenditures in endemic regions. To ensure sustainability, vaccination programs in LMICs require tailored policies and targeted financial support. Policy frameworks must be adapted to local contexts, enabling focused, effective, and equitable implementation. Full article

Background: In rapidly aging societies like Japan, socioeconomic status (SES) plays a critical role in shaping older adults’ health behaviors. Disparities in SES influence access to healthcare, engagement in health-promoting activities, and the adoption of digital health technologies. This narrative review synthesizes current evidence on how SES affects health behaviors among older adults and highlights challenges in promoting equitable and sustainable healthcare in aging populations. Methods: A PubMed search was conducted for English-language articles published up to May 2025 using the keywords “socioeconomic status”, “older adults”, and terms related to health behaviors. Studies were included if they focused on individuals aged 65 or older and examined associations between SES and healthcare use, digital health, complementary and alternative medicine (CAM), supplements, or lifestyle behaviors. Results: A total of 24 articles were identified. Higher SES—typically measured by income, education, and occupation—was consistently associated with an increased use of preventive services, digital health tools, CAM, and healthier lifestyle behaviors such as diet, physical activity, and sleep. In contrast, lower SES was linked to healthcare underuse or overuse, digital exclusion, and less healthy behaviors. Structural and regional disparities often reinforce individual-level SES effects. Comorbidity burden and shifting health perceptions with age may also modify these associations. Conclusions: SES is a key determinant of health behavior in older adults. Policies should focus on redistributive support, digital inclusion, and SES-sensitive health system strategies to reduce disparities and promote healthy aging in super-aged societies. Full article

Background/Objectives: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, with the Asia-Pacific (APAC) region bearing a disproportionate burden. This paper examines HCC challenges within seven APAC health systems, identifies key barriers at each stage of the patient journey, and proposes tailored, actionable solutions. To effectively address HCC challenges, a stepwise approach should prioritise high-impact solutions, focusing on prevention, early diagnosis, and expanding surveillance to maximise health outcomes and economic benefits, while tailoring strategies to each health system’s unique resources and constraints. Methods: A mixed-methods approach was used, including expert consultations from the 2024 HCC APAC Policy Forum, a literature review, and a review of Japan’s HCC management model. Data were collected through workshops and stakeholder feedback from healthcare professionals, policymakers, researchers and patient advocates across Australia, India, Malaysia, South Korea, Taiwan, Thailand, and Vietnam. Results: Key findings include significant disparities in HCC awareness, prevention, early detection, diagnosis, and access to treatment. Common challenges across APAC include limited public awareness, suboptimal surveillance infrastructure, and financial barriers to care. The integration of novel biomarkers and advanced surveillance modalities were identified as crucial priorities for improving early detection. Japan’s multi-faceted approach to HCC management serves as a successful model for the region. Conclusions: A customised and targeted approach is essential for reducing the HCC burden across APAC. The proposed recommendations, tailored to each health system’s needs, can significantly improve patient outcomes and reduce healthcare costs. Effective collaboration among stakeholders is necessary to drive these changes. Full article

Cervical cancer screening is crucial for early detection and prevention. In Japan, women with negative intraepithelial lesion or malignancy (NILM) and high-risk human papillomavirus (HR-HPV) positivity are recommended retest for 12 months, rather than immediate colposcopy. International guidelines differ, and often prioritize early colposcopy for persistent HPV16/18 infections. This study evaluates Japan’s current screening approach, and identifies areas for improvement. A retrospective cohort study analyzed cervical cancer screening data from Saga Prefecture (2019–2021), assessing follow-up adherence, colposcopy referral rates, and CIN2+ and CIN3+ detection among NILM/HR-HPV+ cases. Among 27,789 individuals screened, 2248 (8.1%) were NILM/HR-HPV+. Follow-up adherence after 12 months was 54.4%. Of these, 132 with cytological abnormalities underwent colposcopy, revealing CIN2+ in 27.3% of cases. Additionally, 561 women with persistent NILM/HR-HPV+ underwent colposcopy, with CIN2+ in 7.6% and CIN3+ in 3.9% of cases. Japan’s current NILM/HR-HPV+ management strategy could delay the detection of high-grade cervical lesions. International guidelines favor earlier colposcopy referrals, particularly for HPV16/18+ cases. To improve cervical cancer prevention, Japan should consider a risk-based stratification model, enhance follow-up adherence, expand colposcopy access, and develop a national patient tracking system. Adopting primary HPV-based screening could attain the best global practices, facilitating earlier detection and reducing cervical cancer. Full article

Obesity is a major global health concern related to chronic diseases and rising healthcare costs. While previous studies focused on diet habits, environmental issues, and physical activity, financial literacy remains an overlooked factor in weight management. This study examined the relationship between financial literacy and the body mass index (BMI), using financial literacy as a proxy for rational health decision-making. A quantitative approach was employed, where linear regression analyzed the BMI as a continuous variable and a probit regression assessed overweight, normal weight, and underweight categories. A nationwide survey, the Preference Parameter Study, conducted by Osaka University, Japan, in the United States, provided the data for this study. The results indicate a significant negative association between financial literacy and the BMI, with higher financial literacy linked to a lower BMI and a greater likelihood of maintaining a normal weight. The key control variables, including impatience, gender, education, income, and smoking, also significantly affected the BMI. These findings reflect a strong correlation between financial literacy and the weight status; however, due to data limitations, causal inferences could not be made. We acknowledge the potential endogeneity and the cross-sectional nature of the data as limitations. Thus, while our results suggest a potential role for financial literacy in promoting rational health behavior, the policy implications should be interpreted with caution. Future research should explore targeted interventions across various demographic groups to maximize the impact. Full article

Nanoparticle technology has emerged as a fundamental component across various industries, including electronics, renewable energy, textiles, and medical biotechnology, particularly for targeted drug delivery applications. Commercialization has profoundly impacted economic growth, especially in the pharmaceutical and electronics industries. Moreover, it has improved workforce education and training, generating millions of employment prospects associated with nanotechnology development. By 2024, the Organisation for Economic Co-operation and Development anticipates that the global market for nanotechnology products will attain a value of United States Dollar (USD) 1 trillion to USD 3 trillion, resulting in the creation of over 2 million new employments globally. The swift progression of nanoparticle technology from 2000 to 2024 is primarily propelled by substantial industrial investment in research and development, alongside collaborations with academic institutions. The National Nanotechnology Initiative in the United States (US) has significantly contributed to these developments, with federal funding exceeding USD 30 billion by 2024 since its establishment in 2001. This funding has catalyzed significant advancements in both commercial and research applications of nanotechnology. Patent data highlights this expansion, with China establishing itself as the preeminent nation in nanotechnology patents. From 2000 to 2024, China steadily raised its proportion of nanotechnology patents, accounting for almost 40% of the global total by 2024. The US, Japan, Germany, and the Republic of Korea continued to be significant contributors, together advancing the frontiers of innovation in nanotechnology. In this timeframe, the quantity of nanotechnology-related patents increased by more than 150%, demonstrating the swift growth of the sector. The regulation of nanotechnology in the US is primarily managed by the Food and Drug Administration, particularly about healthcare and biotechnology applications. As the scope of nanotechnology uses has expanded, there is an increasing demand for more extensive regulations concerning potential long-term environmental and health effects. The future trajectory of nanotechnology, both in the US and worldwide, will hinge on continuous invention, economic advancement, and the progression of governmental policy. By upholding a robust regulatory framework and promoting ongoing collaboration between academics and industry, the complete potential of nanotechnology in advancing industrial and societal progress can be actualized. Full article

The COVID-19 pandemic disrupted healthcare systems globally, potentially altering mortality trends for non-COVID-19 diseases, particularly in aging populations like Japan’s. Assessing these impacts is essential for responsive healthcare planning. We analyzed Japanese vital registration mortality records from January 2018 to December 2021 for adults aged 25 and older, excluding COVID-19-related deaths. Data were stratified by sex and ICD-10 cause-of-death chapters. Poisson regression models assessed changes in mortality rates and trends, incorporating pandemic-related variables and interactions between time, age group, and the pandemic term. Among the 4,920,942 deaths analyzed, 2,456,750 occurred during the pandemic years. Significant sex-specific changes in mortality trends were observed. Women experienced increases in mortality rates and trends for endocrine, nutritional, and metabolic diseases; skin and subcutaneous tissue diseases; circulatory diseases; and genitourinary diseases, reversing some pre-pandemic declines. Men showed increases in mortality trends for endocrine, nutritional, and metabolic diseases and genitourinary diseases but no significant changes for skin or circulatory diseases. These findings indicate that the pandemic differentially affected mortality trends between sexes, with women experiencing broader increases across multiple disease categories. The COVID-19 pandemic was associated with significant changes in mortality trends for certain non-COVID-19 diseases in Japan, with notable sex differences. Increased mortality among women across multiple disease categories highlights the pandemic’s indirect health impacts and underscores the need for sex-specific healthcare strategies in the post-pandemic era. Full article

Interest in the transition of care for cystic fibrosis (CF) patients has grown significantly over time, driven by advancements in treatment that have extended life expectancy. As more CF patients survive into adulthood, the need for structured transition strategies has become a priority for healthcare systems worldwide. Transition programs for CF differ globally, reflecting varying resources and healthcare systems. In North America, the US CF Foundation has fostered adult care since the 1990s, with accreditation standards mandating adult programs and structured transition guidelines, exemplified by the CF RISE program for gradual responsibility shifts. Canada integrates US-inspired models, emphasizing national advocacy and outcomes evaluation. In Europe, approaches varies widely; the UK leads with structured programs like the Liverpool model and robust registry support, while France and Germany adopt multidisciplinary methods. In Australia and New Zealand, youth-centered policies prioritize early planning and access via telemedicine. In Asia, where CF is rare, transitions are less formalized, with some progress in countries like Japan and Turkey, though resource gaps and limited data tracking remain significant challenges. Despite varied approaches across countries, common barriers like resource limitations and psychological readiness continue to challenge successful transitions. Highlighting the importance of centralized, well-coordinated transition programs, recent initiatives have focused on the implementation of national and international CF registries to enhance health outcomes and quality of life. This narrative review provides a global perspective on transition strategies developed across various healthcare systems for CF patients, identifying best practices, common challenges, and outcomes related to the continuity of care. Full article

Background: A decrease in populations could affect healthcare access and systems, particularly in medically underserved areas (MUAs) where depopulation is becoming more prevalent. This study aimed to simulate the future population and land areas of MUAs in Japan. Methods: This study covered 380,948 1 km meshes, 87,942 clinics, and 8354 hospitals throughout Japan as of 2020. The areas outside a 4 km radius of medical institutions were considered as MUAs, based on the measure of areas in the current Japanese Medical Care Act. Based on the population estimate for a 1 km mesh, the population of mesh numbers of MUAs was predicted for every 10 years from 2020 to 2050 using geographic information system analysis. If the population within a 4 km radius from a medical institution fell below 1000, the institution was operationally assumed to be closed. Results: The number of MUAs was predicted to decrease from 964,310 (0.77% of the total Japanese population) in 2020 to 763,410 (0.75%) by 2050. By 2050, 48,105 meshes (13% of the total meshes in Japan) were predicted to be new MUAs, indicating a 31% increase in MUAs from 2020 to 2050. By 2050, 1601 medical institutions were tentatively estimated to be in close proximity. Conclusions: In Japan, the population of MUAs will decrease, while the land area of MUAs will increase. Such changes may reform rural healthcare policy and systems. Full article

A comprehensive analysis was performed, considering blockchain technology (BT) properties in digital health, addressing medicolegal, privacy, and regulatory considerations. Adherence to personal data protection and healthcare regulatory guidelines were analyzed and compared for GDPR (Europe), HIPAA (United States), CCPA (California), PIPEDA (Canada), the Privacy Act of 1988 (Australia), APPI (Japan), and LGPD (Brazil). Issues such as health systems, strengthening and aligning policy orientations and initiatives, and emphasizing the role of data analysis in shaping health policies were explored. The study addressed conflicts between the legal frameworks and blockchain, comparing and suggesting solutions like the revision of laws and the integration of compliance mechanisms. Additionally, it sought to enhance IT-health literacy by integrating the healthcare and legal domains. Ongoing collaboration between legal, health, and IT experts is essential for designing systems that effectively balance privacy rights and data protection while maximizing the benefits of disruptive technologies like blockchain. Full article

In response to the distinctive healthcare requirements of independent, healthy, community-dwelling older adults in Japan and other developed countries with aging populations, the current study examined the differences in factors associated with self-rated health (SRH) between the following two age groups: young–old (65–74) and old–old (75 and above). Age-stratified analysis was used to provide a comprehensive understanding of the unique health challenges faced by these demographic segments and to inform the development of targeted interventions and health policies to improve their well-being. The results of a cross-sectional study of 846 older adults in Yokohama, Japan, who completed self-administered questionnaires, revealed that high SRH was consistently linked with the low prevalence of concurrent medical issues in both age groups (<75 and ≥75) (β: −0.323, p < 0.001 in the <75 group; β: −0.232, p < 0.001 in the ≥75 group) and increased subjective well-being (β: 0.357, p < 0.001 in the <75 group; β: 0.244, p < 0.001 in the ≥75 group). Within the ≥75 age group, higher SRH was associated with more favorable economic status (β: 0.164, p < 0.001) and increased engagement in social activities (β: 0.117, p = 0.008), even after adjusting for age, sex, and economic status. These findings may inform the development of targeted interventions and policies to enhance the well-being of this growing population in Japan and other developed countries. Full article

Recent super-typhoons and torrential rains triggered by global warming have had disproportionately large effects on medically vulnerable people in Japan. This study aimed to identify factors associated with intention to evacuate to the nearest public shelter among family caregivers of pediatric patients receiving home medical care. The study included family caregivers of these patients from the Department of Pediatrics, Fukuoka University Hospital, Japan, including family caregivers of young adults with special healthcare needs. An original questionnaire was prepared drawing on previous studies and used for an interview survey. Overall, 57 individuals provided valid data and were included in the analysis. Factors associated with evacuation intention were non-use of a home ventilator (odds ratio [OR] 3.99, 95% confidence interval [CI]: 1.13–14.03) and not having made arrangements to use a non-public shelter (OR 7.29 95% CI: 1.62–32.88). This means that those who use mechanical ventilation or have secured alternative places to go if they need to evacuate their homes may not use the nearest public shelter in a disaster. We recommend that policy makers consider the use of mechanical ventilation and the availability of non-public shelters as predictors of evacuation behavior when considering disaster preparedness for these patients. Full article