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Chapter 24 Health and Medical Care

  This chapter covers health and medical care.

System of statistics and brief history

  As statistics concerning health and medical care, the Cabinet Office issued a decree concerning family register in 1871. Based on the decree, vital statistics were compiled each year using data on births and deaths submitted by prefectural governments. (Marriage and divorce were added to the survey as survey topics in 1884.)

  The Ministry of Home Affairs began a survey on epidemic diseases, a survey on food poisoning and a survey on doctors, dentists and pharmacists in 1876, 1878 and 1884 respectively. In 1886, the Ministry of Home Affairs started the "Statistical Report on Home Affairs." The report is the predecessor of the present "Statistical Report on Public Health Administration" prepared by the Ministry of Health, Labour and Welfare. The Ministry of Education stipulated a regulation on physical examination of school children in 1897, and started compiling statistics of school children's physical examination in 1900.

  Subsequent to the end of World War II (1945), various statistics were reviewed and reformed in the field of health and medicine. In 1948, the Ministry of Health and Welfare (currently MHLW) started basic statistical surveys concerning health and medical care such as the National Health Survey, Patient Survey and Survey of Medical Care Facilities. In addition to these basic surveys, the Ministry of Health, Labour and Welfare has been carrying out a survey concerning the conditions of patients by disease, a survey concerning the activities and management of various medical care institutions and a survey concerning medical and pharmaceutical products.

National Nutrition Survey

  The first survey was conducted in 1945 only in Tokyo in order to gather data on the health conditions and nutritional intakes of the people and shed light on relationships between nutrition and health. The data are used as basic materials for formulating measures to improve nutrition. In 1946, the target area was expanded, thereby paving the way for the present survey. The Ministry of Labour, Health and Welfare is in charge of the survey.

School Health Survey (Designated Statistics No. 15)

  The statistics were originally derived from physical measurements conducted under the "Regulation for Physical Examination of Students and Pupils" enacted in 1897. The first statistics was the "Statistics on Physical Examination of Students and Pupils" issued in 1900, which marked the outset of the existing school health statistics. Subsequently, the statistics were continually compiled but suspended during the Second World War. After the end of the War, the statistics were resumed in 1948 as the "School Health Statistics" (designated statistics) compiled from the records of physical examinations conducted based on the "School Physical Examination Regulation."

  In 1958, the School Health Law was enacted. The name of the survey was changed to the "School Health Examination Survey" in 1960. It is under the control of the Analytical Research Planning Division of the Lifelong Learning Policy Bureau in the Ministry of Education, Culture, Sports, Science and Technology.

Survey of Physique and Physical Fitness

  The survey was started in 1964 to illuminate the physique and physical fitness of the people, thereby obtaining basic data for instruction and administration of physical training. Since then, the survey has been conducted each year. The survey initially targeted at elementary and middle school children, high school students and working youths. Its target population has been gradually expanded to include university students, technical college students and, then, people of mature age. People of old age were also included in 1998.

  The survey is conducted by the Ministry of Education, Culture, Sports, Science and Technology.

Statistical Report on Public Health Administration Services

  Following the establishment of the Ministry of Health and Welfare in 1938, the Ministry took over several statistical reports on home affairs that had been included in the "Statistical Report on Home Affairs" since 1886. New topics were also added.

  In 1954, the statistical report and the report on the management of the public health center were extensively revised such as clear delineation of the characteristics of the two, thereby laying the foundation of the present statistical report. The statistical report by the Ministry of Health and Welfare was composed of two components - "Report Related to Social Welfare" and "Report Related to Health." In 2000, the latter was changed to the "Statistical Report on Public Health Administration" as a separate statistical report.

  Minister's Secretariat of the Ministry of Health and Welfare is in charge of the report.

Sewerage Statistics

  The Japan Sewage Works Association compiles statistics from the data on plans, facilities and various activities collected from sewerage projects and wastewater processing plants that have been authorized under the Sewerage Law. The statistics are used for planning the expansion of wastewater systems, efficient execution of construction projects and the maintenance and management of wastewater systems, thereby contributing to the improvement of sewerage services.

Survey of Public Facilities

  The Ministry of Internal Affairs and Communications conducts the survey. The purpose of the survey is to grasp correctly the actual conditions of local administration and to provide reference materials for the comparison and analysis of administration level among local public bodies. In principle, the survey is designed to examine the public facilities that basically belong to ordinary accounts among public facilities owned or managed by a local public body. Statistics include data obtained by various surveys.

Statistics on Epidemic Diseases

  In 1874, the government introduced a reporting system by doctors and started a nation-wide statistical system in 1876 on epidemic diseases. In 1880, the "Epidemic Disease Control Regulation" was enacted, thereby starting weekly publication of the epidemic disease statistics.

  After many revisions and additions of epidemics, food poisoning was added to the survey in 1951. The restructuring of the statistics in 1968 led to the publication of the "Preliminary Monthly" and "Final Monthly." The statistics underwent further revisions, and the publication was titled the "Epidemic Diseases Monthly" in 1976 according to the 1975 revision.

  The Ministry of Health, Labour and Welfare compiles statistics.

Survey of Food Poisoning

  In 1878, statistics on food poisoning were compiled through a reporting system on cases of food/drink poisoning and misuse of drugs. The "Statistical Report on Home Affairs" stipulated in 1886 was replaced by the "Statistical Report by Ministry of Health and Welfare" in 1938. The Food Sanitation Law of 1947 mandated the filing of reports on patients of food poisoning. Through subsequent several revisions, a system of "Statistics on Food Poisoning" was separately established in 1976.

  The Ministry of Health, Labour and Welfare is responsible for compiling the statistics.

Comprehensive Survey of Living Conditions of the People on Health and Welfare (Designated Statistics No. 116)

  This survey was created and started in 1986 by integrating the "Basic Survey for Welfare Administration," the "National Health Survey," the "Basic Survey of Public Health Services" and the "Survey of the Living Conditions of the People." The survey is composed of a large-scale survey that is conducted every three years (using a "household questionnaire," "health questionnaire," "income questionnaire" and "savings questionnaire") and a simplified survey that is carried out in the interim years (using a "household questionnaire" and "income questionnaire"). In 2001 a "nursing care questionnaire" was used besides the four questionnaires in the large-scale survey.

  The survey is designed to examine the basic conditions of people's lives such as health, medical care, welfare, pension and income. The survey is conducted by the Statistics and Information Division under the Minister's Secretariat of the Ministry of Health, Labour and Welfare. Its purpose is to obtain basic data required for the planning and management of welfare administration and to provide population for other sample surveys.

Patient Survey (Designated Statistics No. 66)

  The "Survey on the Condition of Disease Viewed from Facilities" was conducted in 1948 for a period of one week. This is the predecessor of the Patient Survey. It became a designated statistical survey in 1953, since which time it had been carried out once a year. Since 1984, however, it has been conducted every three years.

  The Ministry of Health, Labour and Welfare conducts the survey for the purpose of illuminating the number of patients in a hospital or clinic, the condition of a patient, type of medical care he/she receives and how he/she pays medical expenses. The statistics are used as basic materials for medical administration.

Survey of Medical Institutions (Designated statistics No. 65)

  A survey was carried out as the "Survey on the Condition of Disease Viewed from Facilities" in 1948. In 1953, it became the "Survey of Medical Institutions." The survey was separated into a survey for structural statistics, which would be conducted every three years, and a survey for current statistics, which would be implemented every month so as to obtain the monthly change of medical care institutions.

  The Ministry of Health, Labour and Welfare is in charge of the survey.

National Medical Care Expenditure (Estimates)

  In 1948, the Ministry of Health and Welfare (currently MHLW) tried to estimate national medical care expenditure based on the results of the "Survey of the Conditions of Diseases Viewed from Households" and other statistics. Since 1949, the Ministry has been computing gross national medical care expenditure estimates.

  Subsequent to changes in the methods of estimation several times, the Ministry began to estimate medical care expenditure classified by type of medical care in FY 1962. In FY1977, it initiated the estimation of medical expenditure by age bracket and by type of disease/injury and general medical care expenditure. In FY1981, it further expanded its estimation to include medical care expenditure by financial resources, and in FY1984, it added dental care expenditure by age bracket. Since FY1990, it has been compiling national medical care expenditure by prefecture every three years.

Survey of Physicians, Dentists and Pharmacists

  Statistics on medical professionals can be traceable to 1884 for physicians, 1890 for dentists and 1900 for pharmacists. Data for the statistics were gathered under the "Statistical Reports on Home Affairs."

  In 1948, the government proclaimed the Medical Practitioners Law and the Dental Practitioners Law, thereby establishing a registration system for medical professionals. The survey of physicians, dentists and pharmacists was started then as an annual survey. Since 1982, it has been carried out every two years.

  The survey is designed to explore the type of medical practice, the type of license, the year of registration and the age of physicians, dentists and pharmacists. Its primary purpose is to produce basic materials, together with the results of the "Survey of Medical Care Institutions," to enhance administration of medicine and public health. The Ministry of Health, Labour and Welfare conducts the survey.

Survey on Visits to Physicians

  The survey was started in 1996 to examine the perception, behavior and degree of satisfaction among patients from the demand side of medical services. Since then, it has been conducted every three years on the same day with the patient survey. Its purpose is twofold: the first is to look into the particulars of visits to physicians for medical care and the degree of satisfaction with the care which the patient has received, thereby illuminating the patient's perception and behavior concerning medical care. The second is to obtain basic materials for medical administration. The survey is conducted by the Ministry of Health, Labour and Welfare.

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