Health Care in Japan

Foreigners Struggle to Make Sense of
Japanese Health Care


National Study of 
Foreign Patients' Experience of Health Care in Japan

Fortier, et al, LostWithoutTranslation.pdf


DiversityRx: Resources for Cross Cultural Health Care
Osaka University Graduate School of Human Sciences


Foreigners in Japan face significant challenges getting health services. Language and cultural differences mean that foreigners often delay seeking care, have difficulty communicating with medical staff, cannot read essential medical documents, and often feel their concerns are not understood or responded to. These challenges can adversely impact the delivery of health services and lead to poor outcomes.

As Japan increases its participation in the global marketplace through business, education, cultural initiatives and major events like the 2020 Tokyo Olympic and Paralympic Games, its health system must be ready to care for a more diverse population. Having a better understanding of the foreign patient experience can help government, business, and health care leaders address potentially harmful barriers, ease health care provider interaction with foreigners, and improve overall quality of care.

DiversityRx and the Osaka University Graduate School of Human Sciences conducted a national survey in 2014-15 of foreign patients seeking health care in Japan. Through an online, 48-question survey, about 500 foreign residents and visitors to Japan reported their experience accessing care, interacting with health care providers and staff, and coping with cultural and linguistic barriers.

Although respondents reported a high level of respect from Japanese medical staff, they described many challenges to getting the health care they needed. Survey highlights include:

•    57% of respondents said they delayed getting care because of language or cultural difficulties;
•    60% of respondents either needed an interpreter sometimes or chose an English speaking doctor;
•    80% of those who needed, but didn't have an interpreter, said it may have negatively affected the quality of care;
•    55% of respondents said the doctor did not give clear explanations of their condition and treatment;
•    58% of respondents said their questions or concerns were not completely addressed by the doctor.

This report reviews the survey findings and offers recommendations for policymakers, health care leaders, and organizations that have a strong interest in foreign residents or visitors by comparing Japan’s unique situation with benchmark practices and policies from other countries.

Fortier, et al, LostWithoutTranslation.pdf


Project Team

DiversityRx:  Julia Puebla Fortier, Executive Director

Osaka University Graduate School of Human Sciences:  Rie Ogasawara, PhD Candidate,  Dr. Yasuhide Nakamura, Professor

Paula Birung and Esther Jung, Research Interns


For more detailed information about the study or to request an interview, please contact us

For an overview of linguistically and culturally sensitive health services around the world, you may be interested in Migrant-Sensitive Health Services, a paper produced for the 2010 Global Consultation on Migrant Health, sponsored by the World Health Organization and the International Organization for Migration. 


Sample questions from the survey:

At the health provider’s office or hospital:

Could you understand the signs and written documents?

Was it easy to fill out the required forms?

Were they translated into your preferred language?

Communication with Providers:

Did the provider give you an easy to understand explanation about  your condition and the next steps for your treatment?

Did the provider answer all your questions to your satisfaction?


Did you need an interpreter to communicate at this visit?

If you needed an interpreter but did not have one, how did you communicate with the health provider and office staff?

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