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JKT Research Project – palliative care leadership and management in Japan

03 August 2016

JKT Research Project is a cross-national research project started in 2013. It involves three different sub-projects and yearly academic exchanges.

This year, Hospice Foundation of Taiwan had the privilege to invite Professor Yoshiyuki Kizawa from Japan, Professor Young Seon Hong from Korea and Dr Chun-kai Fang from Taiwan to share their point of views in the JKT Research Project Taipei.

Prof. Kizawa is currently the Secretary General of Japan Society for Palliative Medicine (JSPM) and the Designated Professor for the Department of Palliative Medicine of Kobe University Graduate School of Medicine.

He explained that the development of palliative care in Japan was first led by the private sector, with the first hospice, Seirei Hospice, established in 1981. This was the first hospice hospital in Asia. 

In 2007, the Japanese government passed the Cancer Control Act, recognised the needs for palliative care of cancer patients and thus actively promoted palliative care. 

With the increasing needs, JSPM decided to first start with education and certification. Through a train-the-trainer strategy and board certification, qualified palliative professionals can be produced to meet the demand under the supervision of JSPM.

In 2010, there were 1,197,012 registered deaths, and this rate is expected to rise to 1,660,000 by 2040. Among the total deaths in 2010, 30% death of cause was cancer, 16% and 11% were caused by cardiac diseases cerebral and vascular accident respectively. 

Currently, 79% deaths occurred in hospitals and only 3% in hospice. The medical fee for palliative care has been included in Japan’s NHI coverage system for hospitals with certified palliative care units; patients are only required to pay 30% of all medical costs. 

Monthly payment does not exceed a threshold of about USD 1,000. Each patient has the access to freely consult any hospital and make their own decisions.

The education training systems currently provided are: PEACE project for physicians, ELNEC-J for nurses and CLIC for paediatric palliative care. Besides education and certification, benchmarking has been adopted for further follow-up review. 

The current palliative care system in Japan is an organised and comprehensive network, with pragmatic and efficient education system. 

The article was first published in the HFT newsletter.

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