Doctors’ Opinion Papers in Long-term Care Need Certification in Japan: Comparison between Clinic and Advanced Treatment Hospital Settings

Abstract

The Doctor’s Opinion Paper (DOP) in long-term care insurance addresses the patient’s chronic conditions of daily life. It is expected to be written by a doctor who knows the patient well. However, DOPs are sometimes written by doctors at advanced treatment hospitals (ATHs) who might not know the patient well. Japanese government is promoting functional differentiation of medical care. We discuss appropriateness that specialists of ATH who have to provide a higher medical care take on a role to write DOP which addresses the patient’s chronic conditions of daily life. The purpose of this study is to compare DOPs completed by clinic doctors with those completed by ATH doctors, in order to examine who should write a DOP. Data: The DOPs which were used at the Care Need Certification Committee meeting held in March 2012 in Tokyo. Subjects: 403 DOPs for patients aged 65 or older. Results indicated that DOPs written by doctors in ATHs included less information than DOPs written by doctors in clinics. We need to discuss who would be appropriate doctors to write DOPs and how to educate older adults to choose the right health care facility and their doctors for their health condition.

Keywords: Doctor’s opinion paper, certification of need for long-term care, long-term care insurance, advanced treatment hospital, clinic, family doctor, Japan