A New Medical Network System Improves Eating Disorders Treatment in Japan

A medical community network improved many areas, including making initial appointments.

In Japan, health care coverage provides free access to needed treatment.  However, there are only a limited number of physicians in Japan who can treat eating disorders.  While the health system structure differs from many others, the problem of facilitating access to specialized eating disorders treatment is a widespread one. A new study followed the impact of a medical network system that schedules the first treatment visit for eating disorders only by referral from another medical institution, not from patients themselves (BioPsychosocial Medicine. 2017; 11:27).

Researchers at the University of Tokyo report on a new medical network system designed to overcome the inefficiency of the free-access program, including problems with doctor-shopping and  a mismatch between the need for and the supply of health care resources.  The researchers give the example of patients with low-risk operations who nonetheless seek care in tertiary hospitals, creating long waiting times.

In April 2005, the authors began a new medical community network consultation system designed to enhance partnerships with other medical institutions and to better match patients to their tertiary care hospital, which has inpatient and outpatient eating disorders clinics. In this system, referrals to specialized care are made only by the clinic.  They examined measures such as wait time and no-show rate. The data from 342 outpatients (328 females and 14 males) who visited the authors’ eating disorders clinic for the first time between January 2009 sand July 2012. A final group of 128 patients were assigned to the medical network system, and 214 were assigned to the self-referral group.

No-shows and longer waiting times with self-referrals

The no-show rate for the medical referral group was significantly lower than that of the self-referral group (0.8% vs. 17.8%, respectively). In addition, waiting periods from the time of the reservation to the first visit were significantly shorter among the medical network group than the self-referral group (8.4 days vs. 35.5 days, respectively). And, those who were in the medical system network also had a much higher rate of successive visits after their first visit to the clinic. This approach seems to have potential advantages for the system in terms of efficiency. It may also be that such a system of clinic referral may help to address the ambivalence that is often prominent when people with eating disorders contemplate seeking treatment.

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