[Background] In Japan’s cost-effectiveness evaluation system, reference-case analysis is performed from the public healthcare payer’s perspective, and it excludes public long-term care costs. In contrast, the United Kingdom (UK)’s technology appraisal guidance includes public long-term care costs in the analysis. Therefore, the purpose of this study was to investigate how decisions related to public long-term care costs are made in the UK and obtain suggestions for implementing improvements in Japan.

[Methods] Using the technology appraisal guidance (published as of March 10, 2021), the details of costs incurred for neurological disorder treatment that were included in the cost-effectiveness analyses were reviewed and the handling of public long-term care costs was investigated.

[Results] Cost-effectiveness analysis was conducted in 13 of the 30 assessments and included public care costs equivalent to Japanese public care services, such as nursing home admission costs, home-visit care, and home care support and used for decision-making.

[Conclusion] Based on the global trends in health technology assessment (HTA), it is necessary to consider public long-term care costs in Japan’s cost-effectiveness evaluation system in the future.

Purpose: The purpose of this study was to elucidate the effects of working conditions, stress response, and job satisfaction on the medical care provided by physicians.

Methods: A total of 96 hospitals in the Kanto region with >200 beds were selected for the study, and a self-administered questionnaire survey was performed with the cooperation of 614 physicians from 41 participating hospitals. The objective variable, “medical care provision status”, and explanatory variables, “stress response”, “job satisfaction”, etc., were analyzed using structural equation modeling.

Results: “Job satisfaction” had the greatest impact on the “medical care provision status”, followed by “career-promoting work environment”, which had an indirect impact via “job satisfaction”. Furthermore, the burden of “working conditions” increased “physical subjective symptoms” and decreased “job satisfaction”.

Conclusion: For improving the “medical care provision status”, it is important to focus on the “job satisfaction” of physicians and create a “career-promoting work environment”. Additionally, to reduce the “physical subjective symptoms” that decrease “job satisfaction”, there is a need to evaluate ideal “working conditions”.

Unlike those of general wards, nursing managers of long-term care beds need to build cooperative relationships between nurses and long-term care workers. Therefore, this research analyzed nursing managers’ efforts in building a collaborative relationship between nurses and long-term care workers using a prototype version of “the nursing manager’s competence measurement scale for establishing collaborative relationships between nurses and long-term care workers (for the evaluation of long-term care workers)”. This was done focusing on factors affected by the evaluation of long-term care workers. The subjects comprised 834 long-term care workers responsible for long-term care beds in 42 hospitals. Multiple regression analyses were performed using mean scores of the entire scale and five categorical scores as objective variables, and the attributes of long-term care workers and the workplace environment were used as explanatory variables. The results revealed that the workplace environment of long-term care workers influenced the overall evaluation of nursing managers’ efforts, but the influence of personal attributes was not observed.

This suggested that the measurement of nursing managers’ competence in nursing homes through the evaluation of long-term care workers using this scale may be beneficial for nursing care management.

Public healthcare facilities, partially financed by tax funds, have a public responsibility to provide health care services to the community in addition to general services under national health insurance scheme. The purpose of this study is to examine the public role of national hospitals in 29 model catchment areas defined by the regional healthcare strategic plans. Using the Regional Economic Cycle Analysis system, we identified regions that showed higher rate of both (1) dependency on national funds including the reimbursement by the national health insurance system, and (2) income of workers in health care sectors among total income of employees. Nine catchment areas met the criteria. Then, their economic cycle structures were analyzed using the other 20 areas as control. As a result, a similarity in regional economic cycle pattern was observed in the 9 catchment areas: the total account balance was plus in consumption, and minus in investment and others. The primary industry was the healthcare service in all of the 9 areas. In the 20 control areas, only 4 areas showed that specific pattern. These results suggest that public healthcare facilities may have the potential to improve and sustain regional economic cycle in healthcare dependent catchment areas.