On May 8, the position of the new coronavirus under the Infectious Diseases Law will shift to the same “5” category as seasonal influenza.
However, the nature of the virus does not change, and there is a risk of infection in the future.
How much will I have to pay for medical expenses when I move to Category 5?
What should I do if I have symptoms?
We have summarized in detail in the Q&A.
table of contents
Q. How will the burden on patients change?
Q. How will medical institutions change?
Q. What kind of support do you provide to nursing care facilities such as facilities for the elderly?
Q.Which medical institutions did not support Corona?
Q. What are the movements of other medical institutions?
Q. What do experts say?
Q. How will the burden on patients change?
The burden of medical expenses related to corona will increase.
On the 10th, the Ministry of Health, Labor and Welfare decided on a policy to review the cost of free examinations and outpatient medical care, etc.
Currently, the portion of medical expenses paid at the counter is supported by public funds in principle, so out-of-pocket expenses are free of charge. It will be.
However, in order to avoid a sudden increase in the burden, some public funds support will be continued for a limited time.
We'll take a closer look below.
What is the cost of the new corona drug
Assuming that the infection will spread in the summer, the cost of expensive corona treatment drugs will continue to be borne by public funds until the end of September.
After that, we will consider measures for the spread of infection in winter based on the balance with other diseases and the national inventory.
If public expenses were eliminated, for example, the current price of one of the oral medicines,
Lagebrio, would be up to 32,470 yen.
outpatient medical expenses
Up until now, public funds have been used to pay for outpatient care after testing positive, and self-pays were free, but after the transition to Category 5, you will be required to pay your own costs.
Let's look at the case of people under the age of 70 who pay 30% of the cost at the counter (estimate by the Ministry of Health, Labor and Welfare, if the cost of the corona treatment drug is covered by public funds).
If you are prescribed antipyretics and anti-coronavirus drugs, the maximum burden is 4,170 yen.
Up to 4,450 yen for outpatients with seasonal influenza who are prescribed antipyretics and Tamiflu.
will be approximately the same.
Next, in the case of people aged 75 and over who pay 10% of the cost at the counter for insurance medical treatment.
If you are prescribed an antipyretic and a remedy for corona, the maximum is 1,390 yen.
Up to 1,480 yen for outpatients with seasonal influenza who are prescribed antipyretics and Tamiflu.
This means that it will be about the same.
Hospitalization medical expenses
Regarding hospitalization expenses, we will ask for medical expenses and meal expenses.
However, in order to avoid a sudden increase in the burden, as a response to the spread of infection in the summer, we will first take measures to reduce the self-pay limit of the high-cost medical expenses system by 20,000 yen until the end of September.
According to an estimate by the Ministry of Health, Labor and Welfare, among people aged 75 and over, who have a high rate of hospitalization, those who are not exempt from inhabitant tax and whose annual income is up to 3.83 million yen are hospitalized for 10 days due to moderate illness, and the out-of-pocket burden is 37,600. In addition to the yen, a meal fee of 13,800 yen will be charged separately.
Self-pay of inspection
Regarding tests for patients complaining of fever, etc., public expenses for self-payment will end, based on the spread of test kits and fairness with other diseases.
Lodging facilities
The lodging treatment system, in which patients with mild illnesses who find it difficult to secure beds or receive treatment at home are quarantined at hotels, etc., will end.
However, the accommodation facilities for the elderly and pregnant women will continue until the end of September at the discretion of the local government, on the premise that they will bear the costs themselves in consideration of the balance with hospitalization.
From now on
The Ministry of Health, Labor and Welfare will continue to provide support to reduce the copayment of medical drugs and hospitalization costs in response to the spread of infections in the summer. I'm assuming.
Q. How will medical institutions change?
Regarding the medical institutions that treat us when we have symptoms of COVID-19, we have decided to aim for a system that allows us to receive medical care at a wider range of medical institutions than now.
The transition will be carried out in stages by April next year.
Specifically:
Currently, about 42,000 medical institutions nationwide provide outpatient care, but after the transition to category 5, we aim to have about 64,000 medical institutions nationwide.
About 64,000 is the number of medical institutions that have tested even one person for seasonal influenza during the season.
On top of that, prefectures will encourage medical institutions not to limit the patients they accept to family patients, and for the time being, prefectures will continue efforts to announce medical institutions that respond to the new corona.
In addition, hospitalized patients have been accepted mainly at about 3,000 medical institutions that have secured beds for the new coronavirus, but after the transition to Category 5, we aim to have a system to accept them at all about 8,200 hospitals nationwide. is.
In particular, we will actively promote acceptance in the "Regional Comprehensive Care Ward", which provides support such as rehabilitation for the elderly to be discharged from the hospital.
In order to increase the number of medical institutions that accept new patients, we will review the guidelines for measures against nosocomial infections and provide support for the maintenance of necessary equipment for measures.
Special measures for medical fees
Regarding the "medical fees" paid to medical institutions, the special measures that were established to maintain the corona medical care system will be reviewed.
Specifically,
▽In addition to abolishing the addition when announcing that it is a "fever outpatient",
▽Addition when hospitalizing a severely ill person with the new corona will be reduced.
On the other hand,
▽ In addition to maintaining the addition to infection prevention measures within medical institutions,
▽ Assuming that the work of hospitalization adjustment, which has been mainly handled by local governments, is expected, the medical fee will be newly added when adjustment is made. I am planning to set it up.
"Sick bed security fee"
Along with the review of special measures for medical fees, the "bed securing fee" to assist medical institutions that have secured beds to accept inpatients with the new corona will also be reviewed.
The bed security fee is a system called "empty bed compensation", and the amount varies depending on the type of bed.
For general hospital beds at specified medical institutions such as university hospitals, which are priority medical institutions, the upper limit per bed per day was 74,000 yen, but after the shift to Category 5, the limit will be increased to 37,000 yen by the end of September. halve it.
In addition, we have paid a bed securing fee for "resting beds" that were refrained from using when securing a corona bed, but as we aim to transition to a normal medical system, we will make effective use of the bed. From this point of view, the range of "dormant beds" for which bed security fees are paid will be halved.
The response after the end of September will be reviewed based on the expansion of medical institutions.
Grants for securing beds for corona "bed occupancy rate is 60% even at peak times"
"Hospitalization adjustment"
Currently, the adjustment of hospitalization, which is currently being carried out by public health centers, will be gradually shifted to a system of coordination between medical institutions.
Coordination between medical institutions will begin with people with mild symptoms, and will be expanded to patients with severe symptoms from autumn.
On top of that, in addition to promoting the use of IT to share the status of hospital beds between medical institutions, it is also possible to leave the framework of the "hospitalization coordination headquarters" for the time being depending on the actual situation of the prefecture for a smooth transition. increase.
The Ministry of Health, Labor and Welfare plans to ask each prefecture to formulate a transition plan in April to expand the medical care provision system and smoothly adjust hospitalization at medical institutions.
Assuming the spread of infection in winter, the period of the plan is until the end of September, and after that, we plan to make necessary revisions based on the progress of the plan in each region.
Q. What kind of support do you provide to nursing care facilities such as facilities for the elderly?
The Ministry of Health, Labor and Welfare has decided to continue the current support for the time being, as it is necessary to continue to thoroughly implement infection control measures for nursing care providers that provide nursing care services to the elderly who are at high risk of becoming seriously ill.
Specifically, we will continue to provide subsidies for the costs of securing supplies and nursing care personnel necessary for infection control, and support for regular “intensive testing” using test kits for employees working at offices. In addition, we will continue to increase nursing care fees to promote the acceptance of elderly people who have been hospitalized due to infection and have been discharged.
In addition, we will continue to provide subsidies to facilities that pay up to 300,000 yen per person if an infected elderly person cannot be hospitalized and is recuperating at a facility for the elderly. , to set requirements.
There are voices from nursing care sites that such support is necessary even after the transition to Category 5.
Green Hill, a special nursing home for the elderly in Yachiyo City, Chiba Prefecture, is taking thorough infection control measures such as conducting "intensive tests" twice a week to check whether employees are infected with test kits distributed by the local government. increase.
In addition to daily use disinfectants, we also have high-performance medical masks called "N95", as well as gowns and caps.
On the other hand, even as we continued to take measures, a cluster occurred at the facility in January this year due to the infection of the residents.
The infection spread to the staff, and they had to call for support from other offices, which meant that additional labor costs were required.
Q.Which medical institutions did not support Corona?
On the other hand, even clinics that have not been able to accept new corona patients are considering accepting them.
"Kijima Internal Medicine Clinic" in Shinjuku Ward, Tokyo considered accepting patients suspected of being infected when the infection spread, but gave up considering the structure of the clinic and the impact on general patients.
Many of the outpatients are elderly and have chronic diseases such as high blood pressure, diabetes, and respiratory diseases, and there is a high risk of becoming seriously ill if infected.
Since then, patients with symptoms such as fever have asked for a medical examination at a nearby medical institution after inquiring about the situation over the phone. I am considering checking.
When accepting a patient, it is necessary to take measures such as accepting by phone and having other patients come at a different time, and ventilation and disinfection of the hospital after the examination.
Even so, as long as patients suspected of having coronavirus and general patients use the same space, it cannot be said that there is no risk of infection, and some people feel uneasy.
Director Fujio Kijima said, ``The transition to type 5 requires a great deal of consideration for patients. As the person in charge of the clinic, I must always think about how to reduce the chances of infection for patients with risk factors as much as possible."
Q. What are the movements of other medical institutions?
With the transition to category 5, some university hospitals, which have accepted many patients as the "last resort" to treat corona patients, have abolished the dedicated corona wards and returned to the previous medical treatment system. There are places where you can see each department according to your needs.
Tokyo Medical and Dental University Hospital, located in Bunkyo Ward, Tokyo, has accepted about 1,500 patients with severe and moderate illness since April 2020, three years ago when the infection spread. has played a role.
Even now, when the infection situation has calmed down, we have secured 2 beds for severe patients and 20 beds for moderate patients. So no one is hospitalized.
In hospitals, there are more patients who need hospital treatment due to worsening of the original chronic illness than symptoms due to corona, and medical institutions that have secured beds for corona patients as they move to category 5 in the future In response to the review of the subsidy to subsidize the disease, it was decided to abolish the dedicated ward for moderately ill patients from March 15, leaving beds for severely ill patients.
In the future, as a general rule, clinical departments that deal with chronic diseases will accept patients in private rooms, and we are promoting training on infection control, such as how to put on and take off protective clothing, for all staff.
However, in the future, if the number of corona patients increases rapidly, it will not be possible to prepare private rooms for hospitalization immediately, and there is a concern that sufficient medical staff such as nurses will not be available. I assume there is.
Minoru Ueki, Assistant Director of the Hospital, said, "From my experience of dealing with eight waves of the spread of infection, I don't think this will be the end, but there is a great need for treatment of diseases other than corona, and the transition to category 5 will make the national government It is difficult from a management point of view to continue with the current method as the system of subsidies from the hospital changes.This is a very big turning point in the last three years, and I think it will be a burden on the front line, but the hospital is united. I want to overcome it somehow."
Q. What do experts say?
We asked Professor Kazuhiro Tateda of Toho University, a member of the government subcommittee on countermeasures against the new coronavirus, about this review.
As for the cost of testing and outpatient care, he said, ``The cost will be about the same as if you were to see a doctor for suspected influenza, so it is not likely to lead to refraining from seeing a doctor. The cost will be high if you pay yourself, so it is important for the government to provide solid support for a while, and to proceed with the review step by step."
In addition, regarding the addition of medical fees paid to medical institutions when treating corona patients and the review of subsidies to subsidize medical institutions that have secured hospital beds, it is said that "patients will be accepted even after the transition to category 5 In such a case, hospitals will be burdened more than daily medical care, such as consumables for infection control such as protective clothing and masks, inspections, and operation of intensive care units for severely ill patients with COVID-19. It is necessary to continue to maintain a mechanism that the government supports so that we can accept the hospitalization of corona patients with care."
In addition, regarding outpatient care, he said that he is aiming for a system to accept patients at more medical institutions than ever before, saying, "I think that medical institutions that have not treated corona patients until now will be confused if they are suddenly requested to respond. Many medical institutions accept influenza patients, so in addition to measures similar to influenza, it is important to keep the distance between patients and the flow line. It is important to gradually increase the number of medical institutions that cooperate by having them take slightly stronger measures such as securing air and ventilation."