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Healthcare Systems and Quality Assessment of Spine Care in Japan

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Quality Spine Care

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Abstract

The universal health insurance system, regulated by the Japanese government, has provided comprehensive coverage to all citizens in Japan since 1961. This health insurance system covers all permanent residents by public medical insurance. The Japanese healthcare system is characterized by free access to healthcare facilities and good quality of medical care with comparably low prices.

Since the 1980s, the Japanese Orthopedic Association (JOA) scoring systems have been the main disease-specific assessment tools used for evaluating the results of spinal surgery in Japan. Particularly the JOA scoring system for cervical myelopathy is widely used throughout the world. As for lumbar spinal disorders, the JOA scoring system for low back pain, Roland-Morris Disability Questionnaire, and Oswestry Disability Index have been mainly used. Some issues have been reported regarding the JOA scoring systems. They are physician-reported outcome assessments, introducing a potential for observer bias, and they lack evidence of weighting of items, that of clinically important change and of statistical power. In order to overcome these issues, new patient-reported outcome assessments, the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) and the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ), were developed in 2007.

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Acknowledgment

The authors thank Rena Iwasaki for English correction of this manuscript.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Osaka Rosai Hospital, Osaka University Graduate School of Medicine, Sakai, Osaka, Japan

    Motoki Iwasaki

  2. Department of Orthopedic Surgery, Japan Community Healthcare Organization, Osaka Hospital, Osaka, Japan

    Takahito Fujimori

Authors
  1. Motoki Iwasaki
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  2. Takahito Fujimori
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Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Stanford University, Stanford, CA, USA

    John Ratliff

  2. Hospital for Special Surgery, New York, NY, USA

    Todd J. Albert

  3. University of Cincinnati, Cincinnati, OH, USA

    Joseph Cheng

  4. Atlantic Neurosurgical Specialists, Morristown, NJ, USA

    Jack Knightly

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Iwasaki, M., Fujimori, T. (2019). Healthcare Systems and Quality Assessment of Spine Care in Japan. In: Ratliff, J., Albert, T., Cheng, J., Knightly, J. (eds) Quality Spine Care. Springer, Cham. https://doi.org/10.1007/978-3-319-97990-8_14

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  • DOI: https://doi.org/10.1007/978-3-319-97990-8_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-97989-2

  • Online ISBN: 978-3-319-97990-8

  • eBook Packages: MedicineMedicine (R0)

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