Promoting Health System Resilience Through Health Policy Reform for the Ageing Population of Japan: A Rapid Literature Review.

Health system resilience encapsulates the ability of a health system to maintain appropriate standards of healthcare service delivery despite stressors to the system. Insults to the system can come through various forms, including natural disasters and, more recently, the influence of the coronavirus pandemic. Additionally, Japan faces a more insidious health system challenge through its rapidly developing ageing population, coupled with a lower funding base in light of this. Healthcare costs in Japan continue to rise disproportionately and are anticipated to do so due to care and costs related to ageing-related diseases. This rapid review explores the opportunity for health policy reform with respect to the financial and service delivery vulnerabilities of the Japanese health system to improve the capacity of the system to maintain health system resilience. This review does this through synthesising evidence on the current Japanese health finance system and payment models, and evaluates these in the context of current epidemiological and healthcare financing data. In doing so, the review identifies potential reform opportunities, particularly related to restructuring access to healthcare, promoting the use of generic pharmaceuticals, consolidating insurance, and adopting value-based payment models to improve health system resilience.