Aiming to Enhance Medical Care from a Nursing Perspective | Yuko Takeda, Dean of the Faculty of Nursing and Medical Care
2023.01.24
Early in the new year, the Committee for the Study of the Medical Service Fee System of the Japan Federation of Nursing-Related Academic Societies for Social Insurance (Kanporen) was held, with the participation of 58 nursing-related academic societies and organizations. Kanporen is an organization where member societies and organizations collaborate to promote the proper evaluation of nursing-related medical and long-term care service fees, and it engages in various activities. Its main activities include submitting requests and medical technology assessment proposals to the Ministry of Health, Labour and Welfare, holding information exchange meetings, conducting research projects, and giving lectures. This meeting was held to consider what kind of requests for medical service fees and technology proposals Kanporen could submit for the 2025 revision of medical service fees.
In Japan's healthcare system, under the universal public medical insurance system that mandates enrollment for all citizens, anyone can receive necessary medical treatments and services. This system does not apply to all medical services; its application is reviewed in line with changes in disease patterns and advances in medical technology, with revisions made once every two years. The revisions are discussed by the Central Social Insurance Medical Council, an advisory body to the Minister of Health, Labour and Welfare, and related organizations submit requests and proposals for consideration. These proposals are submitted through channels such as the Japan Medical Association, the federation of surgical societies for social insurance, the federation of internal medicine societies for social insurance (Naihoren), and Kanporen.
At the Kanporen meeting, 57 requests were proposed based on the idea that to disseminate the effective nursing support practiced with ingenuity by nursing professionals who strive to maintain and promote people's health in clinical settings, it needs to be incorporated into the medical service fee system. The subjects of these proposals ranged from children to the elderly, and the settings for support were diverse, including emergency outpatient clinics, operating rooms, and home visits in the community. The content varied widely, including patient guidance for the effective implementation of newly introduced medical treatments, specialized care to ensure safety and comfort, requests for additional fees for nurses educated to provide more specialized nursing, and requests for appropriate medical teams and staffing in special settings. All proposals must demonstrate their expected effects, and the academic societies planning to submit them take the lead in conducting thorough research and studies.
I participated on behalf of the Japanese Society of Genetic Nursing. In clinical practice, a great deal of genetic/genomic information is now being utilized. In cancer care, in particular, this information is used to select treatment methods, and in the process, some hereditary cancers are being diagnosed. In the case of hereditary cancer, if a diagnosis is made through genetic testing not only for the patient but also for their blood relatives, the use of medical care for early detection and treatment of cancer becomes essential. However, under the current system, medical care for blood relatives who have not yet developed the disease is not covered by insurance. Therefore, we are preparing to submit a request to expand insurance coverage to include such medical care. Although this is not support provided by nursing professionals, it responds to the expectations for medical care expressed by patients with hereditary cancer and their families. The proposal is scheduled to be submitted not only by Kanporen but also by Naihoren, which includes many medical societies related to genetic medicine and cancer care, and we aim to achieve this through collaboration.
Amidst the rapid progress of medicine, it is extremely difficult to decide what and how to include under insurance coverage to protect the nation's health, and how to allocate a limited budget. From the perspective of nursing, which aims daily to restore, maintain, and promote health alongside patients, I intend to continue advocating and working to ensure that necessary nursing, care, and medical technologies become widely available.
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