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Japan doubles payments to hospitals for worst coronavirus cases

Apr 18, 2020 (Nikkei) - Japan's health ministry on Friday decided to double reimbursement to hospitals for treatment of severely ill coronavirus patients, seeking to help ensure the health care system has enough capacity and staff to handle the rising tide of cases.

Starting Saturday, hospitals will be paid 160,000 yen to 280,000 yen ($1,480 to $2,560) for each day that a COVID-19 patient stays in an intensive care unit. Patients will continue to be exempt from the 10% to 30% copayments they are usually charged.

The move is part of a government effort to "improve compensation for all the doctors, nurses and medical staff working hard to save lives at this moment," Prime Minister Shinzo Abe told a news conference. Under Japan's universal health care system, hospitals receive reimbursement from the government for the care they provide.

The extra compensation is also meant to help hospitals secure more ICU beds. ICUs are equipped with lifesaving equipment such as ventilators and ECMO machines, which oxygenate blood outside the body when the lungs or heart cannot properly function.

Japan has only about 5 ICU beds per 100,000 people, compared with 35 in the U.S. and 30 in Germany. This is not enough to accommodate the number of seriously ill patients the government expects to see at the peak of the outbreak. Many facilities are already short on space, with some reportedly turning away suspected coronavirus cases.

Personnel shortages are an issue as well. ECMO units, for example, must be staffed by multiple nurses to ensure round-the-clock care. To provide proper treatment while minimizing the risk of infection, coronavirus cases require two to four times the usual number of staff needed for a seriously ill patient, according to sources including the Japan Society of Intensive Care Medicine.

Reimbursement will also be doubled for treatment in high care units, which are a step down from ICUs, to as much as 140,000 yen per day. This will apply even to normal units that meet certain staffing conditions.

For moderately ill patients, the government will pay up to 21,500 yen per day on top of normal admission fees, up from a maximum of 12,000 yen.

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