PMID- 15384719
OWN - NLM
STAT- MEDLINE
DCOM- 20041014
LR  - 20061115
IS  - 1344-4964 (Print)
IS  - 1344-4964 (Linking)
VI  - 52
IP  - 8
DP  - 2004 Aug
TI  - Thoracic surgery residency program and health care system in the United States.
PG  - 401-6
AB  - The Japanese Board of General Surgery as well as the Japanese Board of Thoracic 
      Surgery voted to change the educational and training requirements for 
      certification eligibility. The health care system has been modified due to a 
      reduction of the budget for national health care, such as introduction of 
      Diagnosis Related Groups (DRG)/Prospective Payment System (PPS). Several problems 
      regarding the system have already been discussed in the United States, ranging 
      from 30-year experience of residency program to 20-year experience of health care 
      system. In a residency requirement, training period became longer in Japan than 
      in the United States, although number of cases required is ten times less in 
      Japan. The General Surgery Board now became mandatory in Japan, whereas optional 
      in the United States. Interprogram transfer is possible in the United States, but 
      not in Japan. Quality control has been organized for Thoracic Surgery in the 
      United States, but the Japanese counterpart needs more work. In health care 
      system, health insurance is mandatory and operated publicly in Japan while the 
      United States counterpart is mostly optional and managed privately. Malpractice 
      suits are 7-8 times more frequent in the United States. DRG/PPS health care 
      system was temporarily useful in reducing the national budget for health care in 
      the United States. However, an incentive to treat patients with uncomplicated 
      diseases and short hospital stay increased the expenditure. In order to control 
      this, Peer Review Organization has been established and restricted the 
      physician's activities. Because health insurance is optional in the United 
      States, people opt for cheaper health insurance with greater benefits. So the 
      health insurance companies with huge number of customers have had strong opinions 
      over physicians and hospitals. This also has created restrictions on practice. 
      These potential problems may occur shortly in the Japanese residency program and 
      health care system as well. Thus, preventive strategies may be needed.
FAU - Takeuchi, Koh
AU  - Takeuchi K
AD  - Department of Cardiac Surgery, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 
      113-8655, Japan.
FAU - Otaki, Masaki
AU  - Otaki M
FAU - Kitamura, Nobuo
AU  - Kitamura N
FAU - Odagiri, Satoru
AU  - Odagiri S
FAU - Maeda, Katsuhide
AU  - Maeda K
FAU - Takaoka, Tetsuhiro
AU  - Takaoka T
FAU - Murakami, Arata
AU  - Murakami A
FAU - Takamoto, Shinichi
AU  - Takamoto S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Japan
TA  - Jpn J Thorac Cardiovasc Surg
JT  - The Japanese journal of thoracic and cardiovascular surgery : official 
      publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka 
      Gakkai zasshi
JID - 100884261
SB  - IM
MH  - Delivery of Health Care/economics/*organization & administration
MH  - Humans
MH  - Insurance, Health/economics
MH  - Internship and Residency/*standards
MH  - Japan
MH  - Specialty Boards/*standards
MH  - Thoracic Surgery/education/*standards
MH  - United States
EDAT- 2004/09/24 05:00
MHDA- 2004/10/16 09:00
CRDT- 2004/09/24 05:00
PHST- 2004/09/24 05:00 [pubmed]
PHST- 2004/10/16 09:00 [medline]
PHST- 2004/09/24 05:00 [entrez]
AID - 10.1007/s11748-004-0021-3 [doi]
PST - ppublish
SO  - Jpn J Thorac Cardiovasc Surg. 2004 Aug;52(8):401-6. doi: 
      10.1007/s11748-004-0021-3.