Fukuda Haruhisa Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Japan
Imanaka Yuichi Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Japan
Background: Unlike in many other countries, patient safety (PS) in Japan has been promoted under the social insurance medical fee schedule, with the implementation of preferential medical fee paid to medical institutions as incentives. Meanwhile, many hospitals do not assign a full-time physician as PS manager at PS division due to the shortage of physicians.
Objective: The Health Ministry in Japan has been promoting PS by utilizing the preferential patient safety countermeasure fee (PPSCF) since 2006. This study aims to address the potential of pharmacists for PS at hospitals implementing the PPSCF.
Methods: A nationwide questionnaire survey targeting 2,674 hospitals with the PPSCF was performed from 2010 to 2011. Of the 669 hospitals that responded, 627 hospitals were eligible for analysis, including 178 hospitals implementing PPSCF 1 with 400 beds or more (group A), 286 hospitals implementing PPSCF 1 with 399 beds or fewer (group B), and 163 hospitals implementing PPSCF 2 (group C).
Results: Although the mean values of PS activities for nurses were the highest among physicians, nurses, and pharmacists, the values per person recalculated for pharmacists were the highest, and the ranges of the values per person for pharmacists were narrowest across the three professional groups. For example, the number per person of incident reports filed in group A was 2.37 ± 0.30 for pharmacists, 1.14 ± 0.11 for physicians, and 2.09 ± 0.31 for nurses (p = .002). For pharmacists, those values were 2.37 ± 0.30 in group A, 2.43 ± 0.14 in group B and 2.35 ± 0.19 in group C (p = .802).
Conclusions: Across health professionals, pharmacists may have the most potential for PS under the social insurance medical fee schedule in Japan.
Universal health insurance in Japan
Social insurance medical fee schedule
Pharmacists’ potentiality for patient safety
Shortage of health professionals
Preferential patient safety countermeasure fee
Journal of Hospital Administration