Awareness of social insurance, welfare systems, and home medical care among rheumatologists in Japan: a cross-sectional study.

OBJECTIVES

To assess rheumatologists' awareness of social insurance, welfare systems, and home medical care for rheumatoid arthritis (RA) patients in Japan.

METHODS

An anonymous, web-based questionnaire was distributed to 5 128 members of the Japan College of Rheumatology between April 11 and 30, 2024. The survey covered demographics, knowledge of support systems, and attitudes towards home medical care.

RESULTS

A total of 478 rheumatologists responded (response rate 9.3%). Whilst over 80% had some understanding of the High-Cost Medical Expense Benefit and Long-Term Care Insurance systems, knowledge of the Disability Pension and long-term care facility characteristics was limited. About 73% reported facing difficulties in patient support due to insufficient knowledge. Medical Social Workers played a central role in providing patient support; however, their availability was limited in smaller clinics. Although 95.3% of respondents recognized the growing need for home medical care, only 24.5% had practical experience. Major concerns included the lack of RA expertise amongst physicians caring for patients living at home and challenges in medication management after care transition.

CONCLUSIONS

Despite recognizing the importance of integrating social support and medical care, significant gaps remain in rheumatologists' knowledge and engagement, especially in home care settings. Educational and systemic improvements are needed.