Hospice Business

With Japan’s declining birthrate, aging population, and numerous deaths, a shift in national healthcare policy, and the depopulation of regional areas due to shrinking population, many regional hospitals are becoming exhausted, and some of them are experiencing management difficulties. These have become major issues in the Japanese healthcare industry.

Such hospitals provide regional medical care, providing outpatient care, detailed examinations, inpatient care, and emergency care, while facing a chronic shortage of physicians. This situation has led to a negative spiral of excessive workloads, forcing hospitals to reduce their medical services and making their management more difficult.

The exhaustion and failure of hospitals, which are the cornerstone of regional medical care, could lead to the breakdown of regional medical care. In addition, even though the country as a whole has an excess of hospital beds, secondary and tertiary medical areas sometimes have an insufficient number. This regional disparity in medical resources cannot be ignored.

When Keiichi Shibahara, the founder of the company, moved from his role as a researcher to become an entrepreneur, he assumed that these medical issues would spread to more regions in the near future. Accordingly, he decided that the “revitalization of hospitals and regional healthcare” would be the theme to tackle (see the “Message from CEO”).

To achieve this revitalization, Mr. Shibahara came up with the idea of having in-home “hospital beds” with outsourced physician functions. By outsourcing the functions of physicians from hospitals that provide acute, chronic, and terminal care, we lower costs significantly by reducing such services as detailed examinations, outpatient care, and emergency care. This new-concept facility specializes in chronic and terminal care and maintains a satisfactory nursing system. The facility has no resident doctors, but we share hospital beds with local family doctors, who provide home visits, as necessary.

We have applied this idea to revitalize regional hospitals that were operating in the red and succeeded in rebuilding their management. At the same time, we have demonstrated the social significance of maintaining and continuing to respond to the chronic and terminal care needs of the community. We established this case as the first model of Ishinkan. Since then, we have been opening and operating Ishinkan facilities in line with our business mission to strengthen and revitalize regional healthcare.

The Japanese government is pushing for a shift from hospital-based medical care to community-based medical care to provide medical care more efficiently. However, under this system some people have limited opportunities for receiving care and living comfortably after being discharged from the hospital. These include people with high medical dependency, such as those who cannot be taken off the artificial ventilator, who suffer from neurodegenerative diseases, or who suffer from terminal cancer. When patients no longer require treatment at acute care hospitals, they are deemed to be in stable condition and are encouraged to leave the hospital, but even after that, they need to be cared for 24 hours a day to monitor any sudden changes in their condition. However, in many cases no appropriate place is available to accept them after discharge from hospitals.

The Ishinkan business responds to such pressing needs. Chronic and terminal care requires less input from doctors than acute care. Even if no doctor is in residence, as would be the case at a hospital, necessary medical care can be provided by regular or ad-hoc visits from the family doctor.

By having a nursing system comparable to a hospital ward and working closely with local medical professionals, Ishinkan facilities provide high-quality medical care for people with high medical dependency.

Ishinkan is a social problem solving business that benefits all three parties: patients, local communities, and medical professionals.

Ishinkan is a unique healthcare facility based on the concepts of outsourcing physician functions and platform of regional healthcare where local doctors and others gather. Ishinkan is also a model that achieves significant cost savings by reducing various functions from hospitals. It can be rolled out flexibly in areas with high needs, including regional areas facing depopulation, and can respond flexibly to region-specific medical needs. As the physician function is outsourced, the opening of Ishinkan facilities does not cause the scattered allocation of physicians; they are integral to the regional medical infrastructure.

By opening and operating Ishinkan facilities, we bring various benefits to local stakeholders. We aim to respond to the needs of people with high medical dependency, help to correct regional disparities in healthcare, and become an indispensable platform for regional medical care.