The medical expenses in diabetes outpatient: The health-care systems affect accounting and hospital management, and issues in diabetes treatment in Japan

Abstract

We analyzed the medical expenses per diabetes outpatient (annual and per visit) in one medical treatment facility specializing in diabetes in Japan and the USA. We discuss how differences in the health-care systems in the two countries affect accounting and hospital management, and issues in diabetes treatment in Japan. While time and effort spent during each visit on self-management education and consultation for each individual at the Joslin Diabetes Center is significantly longer and greater than that Yokogawa clinic in Japan, unexpectedly, it was not excessively costly. Meanwhile, the costs recovered were substantially below invoice at Joslin, resulting in an unstable income. At Yokogawa clinic, clinic stably received full refund as invoiced by clinic with remuneration system. Issues in Japan include increasing the time for advanced education of patients, and clarifying the roles of doctors, staff and management so as to coordinate an environment in which specialists can work effectively.