A Preliminary Study on the Knowledge and Attitudes of Physicians at Two University Hospitals towards the Medical Insurance System of Japan

Abstract

In this preliminary study, we surveyed the physicians at two academic hospitals on their knowledge of and attitudes toward the medical insurance system in Japan. Most of the physicians had not read the "Ministerial Ordinance on Insurance Medical Institutions' and Insurance Medical Doctors' Medical Treatment under Health Insurance." Of the 433 physicians who filled out the questionnaire completely, 34% had either not read or rarely read the "Medical Fee Point List." Most (89.1%) of the physicians knew that there is a stepwise reduction in the hospitalization fee as the length of a patient's hospital stay increases. However, approximately 30% did not know the stipulation of obtaining an informed consent from the patient prior to blood transfusion. As for the right of patients to see their medical care remuneration statements, which was decided by the government in 1997, 26.8% of the physicians did not know this rule. Physicians who had read the "Ministerial Ordinance on Medical Treatment," were more likely to read the "Medical Fee Point List" frequently; were more likely to know the stipulation about diminishing hospitalization fee; were more likely to know that an informed consent must be obtained prior to blood transfusion; and were more likely to know that patients had a right to see their medical care remuneration statements. The longer the clinical experience of the physician, the more likely that the physician had read the "Ministerial Ordinance on Medical Treatment" and know the other stipulations well. In these two academic hospitals, it is important to establish educational seminars for physicians on the guidelines of the medical insurance system so that physicians will become familiar with the medical insurance system quickly.

Evaluation of the Total Design Method in a survey of Japanese dentists

“…A mail survey conducted by one of the local Japanese dental associations had a response rate of 10% (unpublished data). Mail surveys reported in the Japanese medical literature had response rates ranging from 49 to 90% [4-8]. Research subjects in the various studies were the physicians and residents working at two private University hospitals (Response rate 49.1%) [4], the institutions belonging to an oncology group (Response rate 90.2%) [5], the council members of the Japanese society of child neurology (Response rate 72.8%) [6], ophthalmologists in hospitals and clinics (Response rate 73%) [7], and psychologists (Response rate not given) [8].…”

“…Only two of the five, for example, provide the source of the mailing lists. In two of the surveys, questionnaires were sent to a representative at each hospital or institution rather than to individuals directly [4,5]. None of the five papers indicated whether the studies were sponsored by a professional association, or university or other group.…”

“…None of the papers explained whether an incentive was included in the mailing of the questionnaire. Other details generally missing were the length of the questionnaire (missing in 2/5) [4,6,8], telephone contacts for more information (missing in all 5) or assurance of confidentiality (missing in all 5).…”