Health April 2014

Hospitals: UK vs japan

Length of stay, language, birth, kids and pain relief

  • Level of care is similar to that of other developed nations
  • Four- to five-night stay standard for childbirth
  • Extensive testing and overnight stays for routine procedures

A stint in hospital anywhere can cause anxiety, but even more so when it occurs in an unfamiliar country. Non-Japanese patients’ main worry is about the ability (or inability) of medical staff to speak English and, therefore, communicate effectively about something as important as personal health.

The level of English spoken in hospitals in Tokyo varies widely. Therefore, it is unsurprising that many patients who need to undergo non-urgent procedures choose to go home for these.

However, if you do end up in hospital during your time in Tokyo, rest assured that the level of care you will receive is generally the same as in any other developed country.

Differences with the UK
First, the length of hospital stay is generally longer in Japan than in the UK. Even for relatively simple procedures that would commonly be performed as day surgery elsewhere, hospital admission is often required.

Patients are frequently admitted on the day prior to their surgery and discharged the day after, requiring a two-night stay for general procedures.

This length-of-stay difference is particularly noticeable in obstetrics. In the UK, following a normal birth, new mothers are typically discharged the day after delivery, or even on the same day. In Japan, a four- to five-night stay is average. Some mums (especially first-timers) actually find this extra time very helpful.

Midwives are available at all hours to answer any questions, address concerns and give reassurance—all very important when you are suddenly landed with a new job for which you have had no training!

Plus, getting your meals cooked for you and having a few days of (relative) rest is an added bonus before returning home. For those seasoned mums who are keen to go straight home to attend to older children, early discharges are possible.

Second, you can expect to have more tests done than in England. For routine operations, even for young and healthy people, chest X-rays, electrocardiograms (ECGs) and blood tests are standard.

Some hospitals even give an HIV test as part of the normal admitting routine. In Tokyo, scans such as magnetic resonance imaging (MRI) are much more widely available than in the UK and, thus, are more frequently used. This can lead to earlier diagnosis and treatment.

Another question I am often asked is about the availability of pain-relieving medications. Many patients describe simply being given paracetamol during their hospital stays for painful conditions that are usually treated with much stronger drugs in the UK.

Overall, hospitals are trying to improve this situation. Even the availability of epidurals (for pain relief during childbirth) is slowly increasing.

Nevertheless, if you have a planned admission, be sure to ask your doctor about available pain relief before entering hospital.

Finally, a few words regarding paediatrics. Parents of course worry about the possibility their children will need a hospital stay while in Tokyo.

Typically, their concerns are about hospital regulations, which may not allow a parent to stay overnight with their child during hospitalisation. If your child is staying in a private room, it is usually fine for one parent to stay overnight, and a (small) fold-up bed is provided for a minimal charge.

Parents are also normally excluded from any potentially unpleasant procedures such as taking blood or putting in intravenous (IV) lines. This can be hard to fight against, and usually isn’t a battle that you will win.

Having said that, my two children have both had in-patient stints in Tokyo and the overall level of care received has been excellent.

On a practical note, if you have private health insurance, you can try to arrange for the hospital to bill the insurance company directly. Many large hospitals in central Tokyo are becoming familiar with foreigners who have overseas insurance and, even compared with a few years ago, are now more willing or able to deal with those companies directly.