A newly introduced comprehensive consultation fee in the national health insurance system in Japan: a promotive effect of multidisciplinary medical care in the field of radiation oncology--results from a questionnaire survey

Jpn J Clin Oncol. 2013 Dec;43(12):1233-7. doi: 10.1093/jjco/hyt147. Epub 2013 Sep 25.


Objective: The consultation fee for outpatient radiotherapy was newly introduced in the national health insurance system in Japan in April 2012. We conducted a survey on the use of this consultation fee and its effect on clinical practices.

Methods: The health insurance committee of the Japanese Society of Therapeutic Radiology and Oncology conducted a questionnaire survey. The questionnaire form was mailed to 160 councilors of the Society, the target questionees. A total of 94 answers (58% of the target questionees) sent back were used for analyses.

Results: The analyses revealed that 75% of the hospitals charged most of the patients who receive radiotherapy in an outpatient setting a consultation fee. The introduction of the consultation fee led to some changes in radiation oncology clinics, as evidenced by the response of 'more careful observations by medical staff' in 37% of questionees and a 12% increase in the number of full-time radiation oncology nurses. It was also shown that the vast majority (92%) of radiation oncologists expected a positive influence of the consultation fee on radiation oncology clinics in Japan.

Conclusions: Our questionnaire survey revealed the present status of the use of a newly introduced consultation fee for outpatient radiotherapy, and the results suggested its possible effect on promoting a multidisciplinary medical care system in radiation oncology departments in Japan.

Keywords: consultation fee; multidisciplinary medical care; outpatient radiotherapy; questionnaire survey.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care / economics
  • Fee-for-Service Plans* / economics
  • Fee-for-Service Plans* / legislation & jurisprudence
  • Fee-for-Service Plans* / standards
  • Fee-for-Service Plans* / trends
  • Female
  • Health Care Surveys
  • Health Promotion
  • Health Workforce
  • Humans
  • Insurance Coverage*
  • Insurance, Health*
  • Interdisciplinary Communication*
  • Japan
  • Male
  • Middle Aged
  • Neoplasms / economics*
  • Neoplasms / radiotherapy*
  • Physicians / economics
  • Physicians / supply & distribution*
  • Radiation Oncology / economics*
  • Radiotherapy / economics
  • Referral and Consultation / economics*
  • Surveys and Questionnaires