Cooperation Among Medical Institutions During the COVID-19 Pandemic

2020/08/27

Since my specialization is health policy and health economics, I am interested in the current COVID-19 pandemic. Because I provide support such as data analysis for Tokyo's health policies, I attend health policy-related meetings held in the city between my academic duties and research. When I listen to doctors working on the front lines, I notice that while new problems seem to be arising in various forms, long-standing issues are also being brought to the forefront.

The keyword is "cooperation among medical institutions." This challenge has been repeatedly pointed out for a long time—even now in 2020, the issue of "how regional medical institutions should cooperate to provide appropriate medical care to COVID-19 patients" is being discussed over and over. For example, during the first wave starting in March, it was pointed out that even if COVID-19 patients with mild symptoms were in high-functioning large hospitals, nearby private hospitals refused to accept them due to fears of spreading infection and a decrease in revenue caused by patients with other illnesses avoiding the hospital.

Why is cooperation among medical institutions so difficult? One structural factor is the long working hours of hospital doctors. It is difficult to say whether insufficient cooperation leads to long working hours or if long working hours lead to a lack of cooperation, but the two are inextricably linked. In reality, it is difficult to expect "cooperation" in a form that includes attending to various adjustments from hospital doctors who do not even have enough time.

However, what about now? As of July 6, when this article is being written, unnecessary emergency transport—a long-standing concern—has visibly decreased, scheduled surgeries have been postponed across the board, and there is no congestion in hospital outpatient departments. As a result, many hospitals are expected to see a decrease in revenue due to the pandemic. Conversely, it can be inferred that quite a few doctors have more time on their hands. If the final bottleneck to cooperation is the loss of revenue associated with accepting COVID-19 patients, the government should quickly implement loss compensation measures, and such calls are loud even at the time of writing. By providing incentives for accepting COVID-19 patients, there is a possibility that cooperation among medical institutions, which has been said to be insufficient until now, will progress in a new form. If functional differentiation and cooperation in the region progress and the strain on medical institutions is eased, citizens will be able to resume economic activities to that extent. "How to face long-standing problems" is also required during the COVID-19 pandemic.