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Long-term oxygen therapy in Japan: history, present status, and current problems
Kozui Kida1, Takashi Motegi, Takeo Ishii
1Department of Pulmonary Medicine, Infection, and Oncology Respiratory Care Clinic, Nippon Medical School, Tokyo, Japan. kkida@nms.ac.jp
Pneumonologia I Alergologia Polska
|September 3, 2013
Summary
Long-term oxygen therapy (LTOT) in Japan, covering over 150,000 patients, has improved home respiratory care and quality of life for elderly individuals. Despite its success, recent events highlight remaining challenges in patient support systems.
Area of Science:
- Pulmonary Medicine
- Health Policy
- Geriatric Care
Background:
- Long-term oxygen therapy (LTOT) in Japan has evolved through collaboration between medical professionals, policymakers, and industry since its insurance coverage began in 1985.
- Initially focused on COPD and tuberculosis sequelae, LTOT's application expanded to cardiac and other pulmonary diseases.
- A shift towards home-based care, driven by the need to improve patient quality of life and reduce healthcare costs for an aging population, has positioned LTOT as a key component of modern respiratory management.
Purpose of the Study:
- To review the historical development and current status of long-term oxygen therapy in Japan.
- To highlight the role of LTOT in the transition to home respiratory care for elderly patients.
- To identify advancements and remaining challenges in LTOT provision and patient support.
Main Methods:
- Historical review of LTOT implementation in Japan.
- Analysis of policy changes supporting home care and insurance coverage.
- Examination of the expansion of LTOT indications and patient numbers.
- Consideration of the impact of LTOT on comprehensive pulmonary rehabilitation and healthcare integration.
Main Results:
- LTOT has been publicly funded in Japan since 1985, with over 150,000 patients currently utilizing the therapy.
- LTOT has facilitated a significant shift towards home respiratory care, enhancing the quality of life for elderly patients.
- The therapy supports comprehensive pulmonary rehabilitation and integrated care models involving primary care and hospitals.
- Recent natural disasters have exposed critical unresolved issues in the support systems for patients requiring LTOT.
Conclusions:
- Long-term oxygen therapy is a cornerstone of advanced home respiratory care in Japan, significantly improving patient outcomes and supporting healthcare system reforms.
- The success of LTOT is linked to collaborative efforts and policy support, but ongoing challenges require attention, particularly concerning patient resilience during crises.
- Further development is needed to ensure comprehensive and robust support for all patients receiving LTOT, especially in emergency situations.
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