Article Text

Download PDFPDF
Primary palliative care in Japan: needs estimation and projections – national database study with international comparisons
  1. Masami Ito1,
  2. Maho Aoyama1,
  3. Fliss E M Murtagh2 and
  4. Mitsunori Miyashita1
  1. 1 Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
  2. 2 Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
  1. Correspondence to Professor Mitsunori Miyashita, Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8577, Japan; miya{at}


Objectives We aimed to estimate the potential population that requires palliative care, clarify the relationship between this population and the rate of ageing in Japan, and compare these trends with those of other countries.

Design We used the national death registration data and population projections for Japan to estimate the population in need of palliative care using the minimal estimate method developed by Murtagh et al. Linear regression was used to create a model of mortality using sex, age at intervals of 5 years, and each major disease classification. We calculated the future population in need of palliative care until 2040 and compared the ageing data to those of other countries.

Setting/participants All adults in Japan who died from 1980 to 2040 at intervals of 5 years.

Results The number of people who might need palliative care from 2020 to 2040 will also increase linearly from 1 059 000 to 1 405 000. The proportion of Alzheimer’s, dementia and senility of the total need for palliative care will increase to 43.4% in 2040. The correlation coefficient between the proportion of the population in need of palliative care and the rate of ageing was 0.24 in developed countries.

Conclusion In Japan, the population requiring palliative care in 2040 will be 1.5 times that in 2015. Palliative care needs to be provided urgently for people with Alzheimer’s disease, dementia and senility. The proportion of patients in need of palliative care may not change, although the number of patients requiring such gradually increases in developed countries.

  • Cancer
  • Chronic conditions
  • Chronic obstructive pulmonary disease
  • Heart failure
  • Renal failure
  • Stroke

Data availability statement

Data are available upon request.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors The study conception and design, material preparation, and data collection and analysis were performed by MI and MM. The first draft of the manuscript was written by MI, and all authors commented on previous versions of the manuscript. All authors reviewed the manuscript draft and revised it critically on intellectual content. MA and FM substantially contributed to the manuscript drafting MM supervised the conduct of this study. All authors read and approved the final manuscript to be published. Finally, the guarantor is MM.

  • Funding This work was supported by JSPS KAKENHI Grant Number 20H04024.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.