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Healthcare Systems and Quality Assessment of Spine Care in Japan

  • Motoki Iwasaki
  • Takahito Fujimori
Chapter

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.

Keywords

Universal health insurance Premium Copayment Japanese Orthopedic Association (JOA) scoring system Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) Oswestry Disability Index (ODI) Roland-Morris Health-related outcome assessment 

Notes

Acknowledgment

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

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Motoki Iwasaki
    • 1
  • Takahito Fujimori
    • 2
  1. 1.Department of Orthopaedic Surgery, Osaka Rosai HospitalOsaka University Graduate School of MedicineSakai, OsakaJapan
  2. 2.Department of Orthopedic SurgeryJapan Community Healthcare Organization, Osaka HospitalOsakaJapan

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