Hospital Groups in Japan: Key Research Findings 2022

Medical Facilities Managed by Hospital Groups Account for 15.2% of A Total Number of Medical Care Institutions in Japan

Yano Research Institute (the President, Takashi Mizukoshi) has conducted a survey on the hospital groups in Japan, and found out the business environment, the actual status of their operation, and the profitability of their businesses.

Summary of Research Findings

In this research, a hospital group indicates an organization that manages more than 3 hospitals. Medical facilities owned by hospital groups account for 15.2% of a total number of medical care institutions in Japan (1,246 out of 8,180, based on the public data of Regional Bureau Health and Welfare as of March 2022). The number of beds in the hospital group facilities account for 17.0% of the total number of beds in the country (250,452 out of 1,475,366, based on the same data). Viewing by the type of bed, the hospital groups occupy 15.9% of general beds (139,550 beds), 25.4% of beds for long-term nursing care (70,558 beds), and 12.6% of psychiatric beds (39,360 beds).  

In view of management status by total assets (FY2020), Tokushukai, Meihokai and Meirikai of the IMS Group, Aijinkai of the Aijinkai Group, and Sekishinkai of the Sekishinkai Group are the top performers. For example, total assets of Meihokai expanded to 100 billion yen-plus.

Noteworthy Topics

Hospital Groups Increase Presence in Regions

Looking at the distribution of hospital group facilities by prefecture, Tokyo has the largest number at 173 (27.5% of 630), followed by Osaka at 103 (20.2% of 509) and Kanagawa at 96 (28.6% of 336). Approximately half of the hospital group facilities are concentrated in metropolises with dense population.

By type of geographic expansion strategy, hospital groups can be broadly classified into two segments: Those that ‘expand deeper’, who scale their local presence within certain geographies, and those that ‘expand wider’, who roll out in broader areas such as nationwide or in areas with large population. Against the backdrop of community-based integrated care system (introduced following a revision of the Long-Term Care Insurance Law), many of the hospital groups take ‘expand deeper’ approach, with a strong focus on building a network with community hospitals/clinics. One of the reasons for this situation is that many of the hospital groups do not have a full range of healthcare services. Departments in charge of liaison with medical facilities in the community make efforts to improve patient referral rates (i.e., the ratio of patients transferred from local hospitals/clinics). Moreover, an inclination to establish closer partnership with local medical facilities is witnessed, for the purpose of increasing counter-referral rates (i.e., the ratio of patients to be transferred back to a hospital/clinic where they were originally transferred from, when the patient’s health condition stabilizes).

Research Outline

1.Research Period: April to December 2022
2.Research Object: Administrative authorities, medical institutions, academic experts, etc.
3.Research Methogology: Face-to-face interviews by our expert researchers (including online interviews), literature research (public documents of Regional Bureau Health and Welfare, information disclosed by local governments upon request, etc.), and use of Yano Research Institute Database

What is the Hospital Group?

In this research, a ‘hospital group’ indicates an organization that manages more than 3 medical facilities. Hospitals of public or semi-public establishing organizations are excluded.

<Products and Services in the Market>

Hospitals, medical care

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