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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.

This article analyzes the challenges of infectious disease control under a super-aged society through Japan’s experience with COVID-19.

This article provides an overview of Japan’s COVID-19 measures and their characteristics, discusses their successes and failures, and identifies future challenges.

Japan’s basic strategy for COVID-19 consists of three parts: the border defense (Stage 1), slowing down the spread (Stage 2), and damage control (Stage 3). One key policy feature in Stage 2 and Stage 3 is based on “voluntary restriction”. It had a certain effect, but it was prolonged with each recurring “wave of infection”, resulting in economic exhaustion and people’s dissatisfaction. Thus, the effect of the voluntary restriction has weakened, while the percentage of people who have been vaccinated is improving, making it difficult to predict the damage of the next “wave”. Under the hyper-aged society, it was necessary to identify and protect particularly vulnerable areas, i.e., psychiatry hospitals, chronic care hospitals, and long term care (LTC) facilities. On the other hand, secondary impacts extend to young people. The most serious one is the decrease in births which further accelerates the aging of society.

This study is original as it investigated why Japan’s unique countermeasures against COVID-19 without mandatory lockdown worked well for a considerable period. It also revealed that secondary impacts of the COVID-19 epidemic are broader and more significant than the direct loss of life, and that the social system, especially super-aged society with many vulnerable areas should be reformed in consideration of the threat of infectious diseases. Lessons from the Japanese case may contribute to other countries.

The purpose of this article is to clarify the social burden of Japan’s three major diseases including Long-term Care (LTC) burden.

A modification of the Cost of Illness (COI)—the Comprehensive-COI (C-COI) was utilized to estimate three major diseases: cancer, heart disease, and cerebrovascular diseases (CVD). The C-COI consists of five parts: medical direct cost, morbidity cost, mortality cost, formal LTC cost and informal LTC cost. The latter was calculated by two approaches: opportunity cost approach (OC) and replacement approach (RA), which assumed that informal caregivers were substituted by paid caregivers.

The C-COI of cancer, heart disease and CVD in 2017 amounted to 10.5 trillion JPY, 5.2 trillion JPY, and 6.7 trillion JPY, respectively (110 JPY= 1 US$). The mortality cost was preponderant for cancer (61 percent) and heart disease (47.9 percent); while the informal LTC cost was preponderant for CVD (27.5 percent). The informal LTC cost of the CVD in OC amounted to 1.8 trillion JPY; while the RA amounted to 3.0 trillion JPY.

The LTC burden accounted for a significant proportion of the social burden of chronic diseases. The informal care was maintained by unsustainable structures such as the elderly providing care for the elderly. This result can affect health policy decisions.

The C-COI is more appropriate for estimating the social burden of chronic diseases including the LTC burden and can be calculated using governmental statistics.

The purpose of this paper is to intelligibly demonstrate the effectiveness of face mask wearing as a means to prevent COVID-19 transmission. Through understanding the benefits of wearing masks, it is hoped to facilitate the change of societal behavior and more people are willing to wear face mask.

The paper investigates the 50 states in the United States of America (U.S.) and Washington, D.C. that implemented the mask mandates before September 30, 2020, which are divided into four groups: (1) those implemented the statewide mask mandates before June 5, 2020 when World Health Organization (WHO) recommended mask wearing; (2) those implemented statewide mask mandates after June 5, 2020; (3) those implemented partial mandates affecting 30 percent or more of the state’s population; and (4) those implemented partial mandates affecting less than 30 percent. Simple descriptive statistics are analyzed.

For the 50 U.S. states and Washington, D.C., the higher the mask wearing rate, the lower the number of COVID-19 cases (correlation coefficient: −0.69 (p<0.001)). For the 23 states with mobility reduction of less than 15 percent, the higher the proportion of population required to wear masks, the lower the number of cases. This can be seen from the difference in the number of cases among the four groups by ANOVA (p = 0.013).

The positive effect of wearing masks is shown based on simple descriptive statistics for intuitive and intelligible understanding, which may lead people to comprehend the importance of wearing masks, and break through their custom, culture, and norms, and wear masks.

The purpose of this study is to increase knowledge and understanding of the relationship between full-time-culture and the outcome for quality and safety of care.

The paper is a literature review with a qualitatively oriented thematic analysis concerning quality or safety outcomes for patients, or patients and staff when introducing a full-time culture.

Identified factors that could have a positive or negative impact on quality and patient safety when introducing full-time culture were length of shift, fatigue/burnout, autonomy/empowerment and system/structure. Working shifts over 12 h or more than 40 h a week is associated with increased adverse events and errors, lower quality patient care, less attention to safety concerns and more care left undone. Long shifts give healthcare personnel more flexibility and better quality-time off, but there is also an association between long shifts and fatigue or burnout. Having a choice and flexibility around shift patterns is a predictor of increased wellbeing and health.

A major challenge across healthcare services is having enough qualified personnel to handle the increasing number of patients. One of the measures to get enough qualified personnel for the expected tasks is to increase the number of full-time employees and move towards a full-time culture. It is argued that full-time culture will have a positive effect on work environment, efficiency and quality due to a better allocation of work tasks, predictable work schedule, reduced sick leave, and continuity in treatment and care. There is limited research on how the introduction of full-time culture will affect the quality and safety for patients and staff, and few studies have been focusing on the relationship between longer shift, work schedule, and quality and safety of care.