# Unpaid Medical Expenses by Foreign Patients in Japan: A Scoping Review

## TL;DR

This paper reviews the issue of unpaid medical bills by foreign patients in Japan and highlights the need for better strategies to address this growing problem.

## Contribution

The study provides a scoping review of research on unpaid medical expenses by foreign patients in Japan, identifying gaps and suggesting future directions.

## Key findings

- Seventeen publications showed challenges in collecting medical expenses from foreign patients.
- Prevention methods like prepayment had limited success in reducing unpaid bills.
- Few policies exist to help institutions manage outstanding expenses from foreign patients.

## Abstract

The increase in international tourists and residents in Japan has necessitated Japanese medical institutions to extend their services to patients, presenting new challenges such as unpaid medical bills. The treatment of foreign patients is further complicated by linguistic, cultural, and social barriers, which heighten the risk of unpaid bills. This highlights the critical need to examine the issue of unpaid medical bills in the context of foreign patient care in Japan. This study investigates trends in research, the regions most affected, and the impact of unpaid medical expenses on patients and healthcare institutions.

A scoping review was conducted using articles indexed in MEDLINE, Web of Science, Scopus, CINAHL Plus, Ichushi-Web (Japanese medical literature), and Google Scholar, with a focus on publications from Japan discussing unpaid medical bills with foreign patients.

Seventeen publications met the criteria, highlighting the difficulties in collecting medical expenses from foreign patients. Prevention methods, such as prepayment and presenting estimated costs before care were suggested but had limited success. There are also few policies to assist medical institutions with outstanding expenses from foreign patients.

This study underscores the urgent need for comprehensive strategies to address unpaid medical bills among foreign patients in Japan, emphasizing further research to develop effective interventions and enhance the overall healthcare experience for these patients.