University Hospitals: Work to Maintain Functions through Stable Management

Editorial

15:04 JST, December 4, 2025

University hospitals play various roles beyond providing routine medical care services, such as conducting medical research, nurturing medical personnel and dispatching doctors to regional hospitals.

In addition, they cannot simply eliminate areas that may easily become unprofitable, such as treating intractable diseases that only have a few patients, for the sake of streamlining. Given these unique characteristics of university hospitals, there is an urgent need to work to achieve sound management in order to maintain their functions.

According to a national association of university hospitals, the combined operating deficit for all 81 national, public and private university hospitals in fiscal 2024 reached a record high of ¥50.8 billion. This deficit is projected to grow even more this fiscal year.

The association said the primary causes are rising labor costs due to wage increases, in addition to prolonged price increases, which have increased costs for medical equipment and materials to be used for treatment.

The worsening business situation is causing disruptions to actual medical care.

At Nagoya University Hospital, multiple items of medical equipment broke at about the same time, as they had been used past their renewal date, forcing some treatments to be suspended.

At Institute of Science Tokyo Hospital, the failure to renovate aging facilities led to flooding due to burst pipes, delaying the start of outpatient services.

University hospitals serve as the “last line of defense” to accept critically ill patients, requiring substantial staff, including those who deal with patients at night. Additionally, expensive equipment is needed to provide advanced medical care services, such as organ transplants and immune cell therapy for cancers.

While cost-cutting efforts are essential for sound management, there is likely a limit to self-supporting efforts alone.

The government has allocated more than ¥1 trillion in this fiscal year’s supplementary budget proposal to support the stable management of medical institutions, including general hospitals, as well as wage increases for medical personnel.

Specifically, it includes measures such as providing ¥195,000 per hospital bed and additional payments to hospitals that accept more ambulances.

In addition, ¥34.9 billion will be allocated to strengthen educational and research functions at university hospitals.

While implementing immediate measures is good, ways to change the structural problems that often lead university hospitals into financial difficulties must be considered.

For example, in the discussions on revising medical service fees paid to medical institutions, which will be held in a full-fledged manner going forward, one idea to consider would be increasing the payments for university hospitals so that advanced and other medical care services can be provided without any issues.

It is also important to reorganize the medical system according to regional needs.

There is a need for university hospitals and nearby medical institutions to discuss how they will support regional medical care services, including the division of their roles, and to put the results into practice.

(From The Yomiuri Shimbun, Dec. 4, 2025)