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[DX x Medical] The 2025 problem, measures to be taken before the collapse of medical care and prospects!

Japan has become one of the countries with the highest average life expectancy and healthy life expectancy in the world. However, with this aging population, various problems such as labor shortages and tax problems have arisen, and there are also problems such as pension problems and shortages of nursing care staff.

In the healthcare field, which is expected to expand further, we will use new technologies such as digital, IoT , big data , AI, and robots to support the future of the medical industry and healthy lifestyles. is required. In this article, I will explain the current situation of the medical industry and measures to address the issues.

Contents

  • Current state of the medical industry
    • 2025 problem
    • Market expansion
  • Challenges in the medical industry
    • Shortage of medical workers
    • Regional disparity
    • caregiving issues
  • Future outlook of the medical industry
    • From treatment to prevention
    • Smart healthcare service
  • summary

Current state of the medical industry

It is no exaggeration to say that the countdown to the collapse of medical care has begun due to the increase in the number of elderly people and the decrease in the number of births in Japan.

I would like to analyze the current situation of the medical industry, which is closely related to people’s lives.

2025 problem

Japan’s population aging rate was about 7% in 1970 (aging society), about 14% in 1994 (aging society), 21% in 2007 (super-aging society), and exceeded 28% in 2018. I was. Looking at this process, it can be seen that Japan has already surpassed the super-aged society and entered the next era.

The 2025 problem refers to the fact that in 2025 , the so-called baby boomer generation, born during the first post-war baby boom (1947-1949), will reach the age of 75, and Japan will become a super-aging society. It refers to the general term for problems that are said to occur due to

Elderly people are more likely to get sick than younger people, go to the hospital more often, and are prescribed more types and amounts of medicine. As a general rule, elderly people pay only 10% of their own medical expenses, and the rest of the costs are covered by the financial resources of the national and local governments. .

According to an estimate by the Ministry of Health, Labor and Welfare, the amount of insurance benefits for medical expenses will be 54 trillion yen in 2025, an increase of about 12 trillion yen from 2019. Currently, measures such as raising the consumption tax are being implemented, but it can be said that the situation is still far from catching up.

A shortage of hospitals and doctors is also a problem. . Acceptance of critically ill patients, difficult treatments, and detailed examinations are naturally limited to large hospitals with beds. However, due to deteriorating cash flow and a shortage of working doctors, even large, well-known hospitals are starting to sell themselves. If large hospitals cannot accept patients, they will not be able to spend their old age with peace of mind no matter where they live.

On the other hand, the young population is declining, and in Japan, the labor force of the young generation basically supports the lives of the elderly. becomes.

Even now, in Japan, where the declining birthrate and aging population are becoming more serious, the 2025 problem, which is approaching in a few years, can be said to be a “problem directly linked to our lives” that could shake social security such as medical care and nursing care.

Market expansion

This graph shows changes in the number of workers by industry. With the aging of the population, the number of medical workers will continue to increase, and in 2030, the number of workers in the medical and nursing care industries will surpass the manufacturing, wholesale and retail industries.

Among the four major industries, the medical and welfare industry is the only one showing stable growth, and is expected to become an important industry that influences the Japanese economy.

According to a survey by the Ministry of Economy, Trade and Industry, the global market is growing by more than 9% every year, and the market size of the medical industry in Japan is 16 trillion yen in 2013, 26 trillion yen in 2020, and 37 trillion yen in 2030. It is estimated that it will grow to

In addition, as part of the national strategy, the country aims to extend healthy life expectancy, reduce medical expenses, create jobs, and strengthen international competitiveness, and further growth is expected.

Challenges in the medical industry

Shortage of medical workers

The management situation of Japanese medical institutions is generally not very good, and it is said that 40% of hospitals in Japan are operating at a loss. With the super-aging society, medical expenses are being curtailed, and hospital management is expected to become even more difficult in the future.

There is also a serious shortage of medical personnel. There are not enough doctors and nurses to care for the growing number of patients, and there is an imbalance between supply and demand. Many healthcare workers are forced to work overtime, and leaving valuable human resources on leave or leaving their jobs is a major concern.

Introduction of ICT (Information and Communication Technology)

“ICT” is an abbreviation for Information and Communication Technology, which means “communication using communication technology”. Currently, active utilization of ICT is required in the medical industry. In particular, there is a high need for ICT utilization related to “remote (online) medical care” and “information sharing and cooperation”, and there are many examples of its use.

Remote diagnosis is attractive because it makes it easier for patients in areas where there are no specialists and elderly people living alone to get medical care. In addition to reducing the burden of hospital visits for patients, it is also expected to reduce the burden on doctors and improve the efficiency of on-site operations.

Also, in the field of information management, there is a service called “Electronic Medication Notebook” that allows you to manage your medication history over time. The electronic medicine notebook is not only useful for health management, but by sharing information with doctors and pharmacists, it can also be applied to prevent interactions, avoid side effects, and provide medication guidance. .

According to a survey conducted by the Ministry of Health, Labor and Welfare in 2018 , about 11% of people possessed an electronic medicine record book, and it is expected that it will spread further in the future.

Introduction of RPA

In medical institutions, the aging of the baby boomer generation will continue to progress toward 2025, when the baby boomers turn 75 years old . Process Automation) is expected to increase.

According to the Ministry of Health, Labor and Welfare’s ” Survey on Doctors’ Work Conditions and Work Style Intentions ,” doctors are responsible for “medical records (records in electronic medical records),” “explanations and consensus building with patients,” “medical administration (medical Approximately 17% (per day 41 minutes) can be shared by other occupations.

As a successful example, when we conducted a “performance verification of RPA utilization in medical institutions” at Tokyo Dental University Ichikawa General Hospital, which has started efforts to introduce RPA since November 2018, it reduced work hours by about 2,453 hours per year. , The Medical RPA Association has announced that a result of about 3.68 million yen is expected to be cost-effective.

Furthermore, in the midst of the corona crisis, medical institutions fell into a negative trap of deteriorating business conditions and a shortage of human resources, but the implementation of RPA will lead to a quick reversal of that situation.

Not only is there a short-term surge in the number of corona-infected patients, but depending on the region, we are being driven into a situation that could lead to a collapse of the medical system over the medium to long term. It can be said that the introduction of RPA in medical institutions will help improve this situation.

Regional disparity

When looking at regional differences in medical care, “medical costs” and “number of doctors” are used as indicators.

<Medical expenses>

When looking at regional differences in medical care, one of the indicators is “medical costs.” While Japan’s national medical expenses continue to increase year by year, regional disparities are also expanding.

Looking at the 2017 ” Analysis of Regional Differences in Medical Expenses ” conducted by the Research Division of the Health Service Bureau, Ministry of Health, Labor and Welfare, we can see the medical expenses in each region and their divergence.

Prefectures with high medical costs in Japan are Saga, Kagoshima, Nagasaki, Oita, and Kagawa. On the other hand, the areas where medical expenses are kept low were Ibaraki, Chiba, Saitama, Tochigi, and Gunma prefectures. It is clearly divided into West Japan and East Japan.

<Number of doctors>

When looking at regional differences in medical care, one of the indicators is the number of doctors.

As of 2036, Niigata Prefecture, which has the greatest shortage of doctors, is estimated to have a shortage of 1,534 doctors in the upper estimates. This means that even if Niigata Prefecture maintains its “most successful state in securing doctors in the past,” there will be a shortage of 1,534 doctors.

In addition, most regional secondary medical areas (areas that provide general health care, from health promotion and disease prevention to hospital treatment) have a large shortage of doctors.

In addition, from 2019, the Ministry of Health, Labor and Welfare will present the “Doctor Uneven Distribution Index” because it is necessary to have an index that appropriately indicates the degree of unbalanced distribution of doctors in order to implement effective measures against the uneven distribution of doctors that meet the medical needs of the region. Did.

“Specifically, (1) changes in medical needs and future population/population composition, (2) inflow and outflow of patients, (3) geographic conditions such as remote areas, (4) gender and age distribution of doctors, (5) units of uneven distribution of doctors (regions, Departments, inpatients/outpatients) are regarded as “five factors related to uneven distribution”, and the “Doctor uneven distribution index” was formulated in consideration of these factors.

The calculation formula presented by the Ministry of Health, Labor and Welfare is “Doctor uneven distribution index = standardized number of doctors / regional population / 100,000 × regional standardized treatment rate ratio”. ”

In particular, by tertiary medical area (area that deals with special medical care that requires advanced technology), the number of doctors is 1.9 times higher in Tokyo (329.0), which has the most doctors, and Iwate Prefecture (169.3), which has the fewest. It became clear that there was a disparity.

Medical network construction

One of the ways to eliminate regional disparities in medical care is the construction of a network that links regional medical services.

We will shift from conventional “hospital-based” medical care to “community co-creation” medical care in which hospitals and clinics share functions and work together inside and outside the region.

5G Telemedicine: Connecting Patients and Doctors Over Distance

Simply put, it is telemedicine that connects doctors and patients via smart devices such as smartphones and televisions. Patients will be able to see patients at home or in mobile clinics without having to travel to hospitals in remote areas.

This facilitates regular check-ups, which leads to preventive medicine and contributes to a reduction in the number of people with lifestyle-related diseases. For doctors, it also has the advantage of optimizing examination work by reducing the time spent on home visits.

No matter where you are in Japan, you can expect to eliminate regional disparities by being able to receive the highest level of diagnosis.

Futuristic medicine that utilizes cutting-edge AI and IoT technologies

Utilizing the latest technologies such as AI, IoT , and smart devices will help eliminate regional disparities.

For example, with the use of IoT-based surgical support robots, even patients living in remote areas such as remote islands can receive treatments from excellent doctors and can also provide advanced medical care.

In diagnosing diseases, it is possible to efficiently process tasks such as “image diagnosis”, “matching with past papers”, and “organizing and inputting data”, and fills in individual differences in technology.

caregiving issues

As the number of elderly people using nursing care services increases, financial resources for nursing care insurance will become tighter.

If the elderly need relatively mild nursing care, it may be possible for the family members living together to take care of them. The demand for special nursing homes is increasing, and nursing care costs are rising.

In addition, mainly in urban areas, the number of people waiting to enter special nursing homes continues to rise, and the number of elderly people requiring nursing care who have nowhere to go is also increasing.

Even for elderly people who require severe care, if they have family members and their pensions are fully paid, it is unlikely that they will run out of money to pay for nursing homes.

However, there is a possibility that the number of cases of relying on public assistance will increase due to the increase in the number of elderly people living alone due to nuclear families and the failure to pay pensions at a young age.

Comprehensive community care system

There are high hopes for the construction of a “community comprehensive care system” as a mechanism to support the elderly in the future.

The integrated community care system aims to enable people to live in a familiar place until the end of their lives even if they are in a state of severe need for nursing care. We aim to

Specific measures to realize this comprehensive community care system include the following.

  • Establishment of Regional Comprehensive Support Center
  • Development of 24-hour home medical care and home-visit nursing care
  • Development of nursing homes for low-income elderly
  • Making use of cafes and universities to create spaces for the elderly
  • Shopping support for the elderly by volunteers

Local governments across the country are considering these efforts to build a comprehensive community care system, and Setagaya Ward in Tokyo is the first to put them into practice.

It is important to further enhance at-home services and self-reliance support services, and create a system that allows the elderly to feel a sense of purpose in life.

Future outlook of the medical industry

From treatment to prevention

We go to the hospital only after we have “some symptoms”. This is the so-called “treatment of the disease”.

However, in an aging society, it is important to extend healthy life expectancy in order to control medical expenses.

For that reason, it is necessary to focus on “disease prevention” to prevent bedridden conditions and lifestyle-related diseases.

In recent years, even in Japan, by combining cutting-edge digital technologies such as IoT, AI, and 5G, we are trying to collect a huge amount of data on people’s behavior, lifestyle habits, and health conditions, and use it for health promotion in various ways. Efforts are underway.

For example, the “NEC Health Checkup Prediction Simulation” developed by NEC Solution Innovators, Ltd. uses AI to analyze the data obtained from health checkups to predict future health conditions.

It is predicted that a variety of related services will appear in the future as a major change from “treatment to prevention” to prevent illness while healthy.

Smart healthcare service

Smart healthcare refers to medical services that utilize IoT (Internet of Things), VR (Virtual Reality), and AR (Augmented Reality).

For example, there are services that use wearable devices equipped with sensors to measure vital signs such as body temperature, pulse, and blood pressure, and transmit the data to appropriate medical institutions through networks.

Wearable devices are information terminals worn on the body and used in the medical field, such as smart watches and VR goggles.

There are four benefits of using smart healthcare.

  • Acquired data can be used for disease prevention and health management of patients themselves
  • It is possible to monitor multiple patients at the same time as improving the efficiency of measurement, which can contribute to solving the labor shortage.
  • Data can be acquired and checked even from remote locations, leading to the spread and promotion of remote medical care.
  • Data collected from various patients can be accumulated and used for epidemiological research as medical big data.

In this way, smart healthcare is considered to have great benefits for both patients and doctors. If it becomes more widespread in the future, the situation surrounding the medical field may improve significantly.

summary

The current situation surrounding the Japanese medical industry is severe, and many issues remain to be resolved, such as the “2025 problem.”

On the other hand, the rapid development of technology is expected to change the situation in the medical industry at a dizzying pace.

It will be necessary to judge the current issues of the medical industry in the short and long term, and then implement countermeasures and reforms accordingly.

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