Special remunerations for family doctors' medical services for those with dementia and children will be created under a plan to reform the medical service fee system to be implemented in April.
The Central Social Insurance Medical Council, an advisory panel to the health, labor and welfare minister, worked out the reform plan for fiscal 2016 and submitted it to health minister Yasuhisa Shiozaki on Feb. 10.
The health ministry is strengthening the roles of local doctors who regularly see patients in their neighborhoods and who give the patients instructions on how to manage their health.
Under the proposed reform, if doctors who operate clinics in regional communities regularly look after those with dementia, they will receive greater remunerations.
Furthermore, a new medical service fee system will be established for doctors who regularly look after children aged under 3, encouraging such medical practitioners to instruct parents over vaccination and give advice depending on the children's developmental stages.
In the meantime, about 160 large hospitals, each with at least 500 beds, as well as 84 medical institutions including university hospitals and hospitals that provide advanced medical treatment will be obligated to charge patients without a letter of introduction 5,000 yen or more for their first checkup (3,000 yen for dental departments) and 2,500 yen or more for the second and later examination (1,500 yen for dental departments). The measure is aimed at decreasing the number of patients with light illnesses who receive treatment at large hospitals and allow such institutions to concentrate on specialized treatments.
A system to evaluate pharmacists' roles in looking after patients in local communities will also be introduced. Basic fees on receiving prescriptions will be lowered for large-scale pharmacies that mostly deal with prescriptions by nearby hospitals.
Medical institutions with a nurse to patient ratio of 1:7 are eligible for higher remuneration, but the scope of eligible institutions will be narrowed down from April. Specifically, the institutions will need to have a ratio of patients with particularly serious conditions to total inpatients of at least 25 percent, up from the current 15 percent. The move is aimed at clarifying the division of roles between medical institutions.