A proposed medical system change in Japan inspired by Swedish primary health care: Important role of general practitioners and specialist nurses at primary health care centers

Japanese citizens of all socioeconomic statuses have benefited from the national insurance system by receiving high-quality healthcare. However, the Japanese healthcare service is facing a severe financial crisis because of the increasing aging society and social security expenses. Many consultations raise medical expenditure and doctors' work overload, which is about to be regulated, but is questionable how the goal can be achieved without delegating doctors' working tasks. Sweden has a similar health index to that of Japan, but the system is different and is anchored by general practitioners and specialist nurses assigned to primary health care centers. They collaborate to share the workload, responsibilities, and patients' continuous care needs. As a result, the number of consultations is kept small, the length of stay in hospitals is shortened, and doctors' working hours are protected. A system change inspired by Swedish primary health care can be a potential solution for Japanese society.