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The purpose of this paper is to examine the health sector reform toward 2040 of Japan as a super-aged society.

This paper discusses the current healthcare policies adopted in Japan and projects the challenges in future as a super-aged society.

Through Japanese experiences, it is considered that Community-based Integrated Care System is useful, which takes into account the perspective of health care users. Being a super-aged society, it is essential for Japan to have more consensus by further removing obstacles, and paying attention to the change of paradigm and the purpose of care.

Based on the case of Japan, this paper serves as a reference for other East Asian countries, which would sooner or later encounter the similar situation of becoming super-aged societies in the 21^st century.

The purpose of this paper is twofold: First, it analyzes demand and supply-side factors that influence patient flows to and from Austria. Second, building on the empirical research and existing conceptualizations, the study offers a general extended framework to guide future comparative analysis.

The paper draws on multiple data sources including a literature review, secondary data, website analysis and semi-structured interviews with patients and health providers. Content analysis was carried out to identify common motives for seeking care abroad and providers' orientation towards medical travel.

Outbound medical travel is largely determined by factors of access, affordability and vicinity, while inbound medical travel is predominately driven by a lack of adequate medical infrastructure in source countries and quality, both in terms of medical and service quality. Providers distinguish themselves according to the extent they take part in medical travel.

The findings emerging from a single country case study approach cannot be generalized across settings and contexts, albeit contributing to a better understanding of current medical travel patterns in Europe.

Unlike most recent contributions, this study focuses both on inbound and outbound medical travel in Austria and investigates patient flows for distinctive treatments and drivers. While analysis of the supply-side of medical travel is often limited to tourism studies, this study provides a critical insight into developments in Europe from a health policy perspective, acknowledging that diverse medical travel patterns in Europe coexist.

Under the Directive 2011/24/EU, medical tourism and cross-border health are interrelated terms regarding the freedom to move to get the most accessible medical treatment into EU Member State within the defined procedures for reimbursement. Little known empirically regarding the efficiency of the cross-border health/medical tourism industry. This study aims to measure its efficiency in Europe for the years 2010-2014, by using Data Envelopment Analysis (DEA).

Data obtained from OECD and the European Core Health Indicators (ECHI), which is collecting the data through Eurostat. Eurostat collects data on health-care activities and provides data on hospital discharges, including the hospital discharges of non-residents and these include hospital discharges of in-patients and day care patients. The analysis uses “DEA.P, 2.1 for windows” by Coelli (1996).

The results show that the Members States health systems were very efficient in handling non-residents in-patients; however, when managing day cases/outpatients, the efficiency scores dropped.

The findings would have significant associations affecting intentions to revisit clinics and the destination country. In addition, will be useful to those seeking a better understanding of the cross-border health and medical tourism industry efficiency.

Extending the findings of the European Commission report (2015c) by examining how well medical tourists are informed about the decision they are making, would be of perceived value. These are important indicators at European level by helping each Member State to measure its medical tourism services.

The purpose of this paper is to disseminate among concerned professionals its certain operational aspects, including some possible implications on health and medical care practices.

It is written on the basis of the author’s special study of a diverse source of information, as well as on author’s practical experience and observation in this particular area.

Special attention is paid to possible public health impacts within a broad social and economic framework, as well as to its impacts on the existing national health care systems in countries, that would possibly lead to certain degree of inequity in health at national level as an important consequence of health development progress.

Knowledge and understanding gained from this paper might be useful in the efforts to develop and manage national health care systems to ensure a reasonable balance in health status of people of all groups.

People with severe persistent mental illness pose a significant challenge to managed care organizations and society in general. The financial costs are staggering as is the community impact including homelessness and incarceration. This population also has a high incident of chronic comorbid disorders that not only drives up healthcare costs but also significantly shortens longevity. Traditional case management approaches are not always able to provide the intense and direct interventions required to adequately address the psychiatric, medical and social needs of this unique population. This article describes a Medicare Advantage Chronic Special Needs Program that provides a Medical Home, Active Community Treatment, and Integrated Care. A comparison of utilization and patient outcome measures of this program with fee for service Medicare found significant reduction in utilization and costs, as well as increased adherence to the management of chronic medical conditions and preventative services.

The past decade has witnessed a tremendous and progressive growth in the number of Nigerians who engage in medical tourism from Nigeria to India. Various commentators have advanced diverse reasons for this trend. However, there is a dearth of research that has sought to provide empirical insights. This paper aims to investigate the decision-making process of Nigerian medical tourists and why they prefer medical tourism to India to medical care locally.

Eight Nigerian medical tourists are interviewed on a one-on-one basis with open-ended questions using purposive criterion sampling technique from an interpretivist mind-set.

The paper identifies two major motivators, namely, inadequate medical infrastructure and poor medical, and customer service from health workers in Nigeria, which spurred medical tourism from Nigeria to India. Further, it finds that first timers premise their decisions on advice from reference groups, while previous personal experiences guide decisions on subsequent medical travels. Findings are explained using the template provided by the theory of planned behaviour.

This exploratory nature of this research provides a useful basis to elucidate the course of decision-making of Nigerian patients so that appropriate marketing communication channels can be applied. It improves the process of recruiting and engaging Nigerian patients and nurturing wholesome relationships between Nigerian patients and hospitals.

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

The purpose of this paper is to explore the formation and composition of “regions” as places of care, both empirically and conceptually.

This paper draws on action-oriented research involving experiments aimed at designing, implementing and evaluating promising solutions to the entwined problems of a burgeoning elderly population and an increasing shortage of medical staff. It draws on ethnographic research conducted in 14 administrative areas in the Netherlands, a total of 273 in-depth interviews and over 1,000 h of observations.

This research challenges the understanding of a healthcare region as a clearly bounded topological area. It shows that organizations and professionals collaborate in a variety of different networks, some conterminous with the administrative region established by policymakers and others not. These networks are by nature unstable and dynamic. Attempts to form new regional collaborations with neighbouring organizations are complicated by existing healthcare governance and accountability structures that position organizations as competitors.

Policymakers should take the pre-established partnerships of healthcare organizations into account before delineating the area in which regionalization is meant to take place. A better alignment of governance and accountability structures is also needed for regionalization to occur in healthcare.

This paper combines insights from valuation studies with sociogeographical literature and provides a framework for understanding the assembling and disassembling of “regions”.

The purpose of this paper is to investigate the way technology affects the provision of prehospital emergency care, upgrading the quality of services offered and significantly reducing the risk of premature termination of the patients.

The paper presents the development of the eEKAB, a pilot emergency medical information system that simulates the main services offered by the Greek National Instant Aid Centre (EKAB). The eEKAB was developed on an agile system methodology. From a technical perspective, the features and the technology were mainly chosen to provide reliable and user-friendly interfaces that will attract many users. eEKAB is based on three important pillars for offering health care to the patients: the “On-time Incident Reporting”, the “On-time Arrival at the Incident” and “Transfer to the Health Center”. According to the literature review, the emergency medical services (EMS) systems that combine all the features are very few.

It reduces the total time of the EMS procedures and it allows for an easier management of EMS, by providing a better allocation of human resources and a better geographical distribution of ambulances. The evaluation displayed that it is a very helpful application for the ambulance drivers as it reduces the ambulance response time to arrive in the patient's location and contributes significantly to the general performance of the prehospital medical care system. Also, the survey verified the importance of implementing eEKAB on a larger scale beyond the pilot usage. It is worth mentioning that the younger ambulance drivers had a more positive view for the purpose of the application.

The paper clearly identifies implications for further research. Regarding interoperability, the mobile app cooperates with the Operational Center of EKAB, while further collaboration could be achieved with other operational ambulance handling center, mainly, of the private sector. The system can evolve to include better communications among the EKAB departments. Particularly, the ambulance crew as well as the doctors should be informed with more incident features such as the emergency signal so that they know whether to open the siren, the patient's name, etc. The authors are currently working on implementing some features to provide effective medical health services to the patient in the ambulance.

eEKAB will have very significant implications in case of its enforcement, such as the reduction of the total time of EMS procedures with a corresponding reduction of the operating costs of an accident management system and an ambulance fleet handling system while in parallel informing in time the doctors/clinics. It will provide better distribution of ambulances as well as of total human resources. It will greatly assist ambulance drivers, while reducing ambulance response time to reach the patient's location. In other words, the authors will have a better performance of the whole prehospital care system.

Providing emergency care before the hospital is of great importance for upgrading the quality of health services provided at the accident site, thus significantly reducing the risk of premature death of patients. This in itself has a significant social implication.

The paper demonstrates a solid understanding in the field of the EMS systems and the corresponding medical services offered. It proposes the development of an effective, feasible and innovative EMS information system that will improve the existing emergency health care system in Greece (EKAB). An in depth literature review and presentation of the adopted new technologies and the respective architecture take place. An evaluation and statistical validation were conducted for proving the high applicability of eEKAB in case of real-life running.