Disaster resilience and recovery in Japan's 2040 care reform

This publication examines how Japan’s efforts to reorganise regional healthcare in response to an ageing and shrinking population could better integrate disaster resilience. Under the 2040 Regional Medical Care Vision, Japan plans to concentrate resource-intensive acute care functions in regional hub hospitals as the healthcare workforce contracts. While the country has well-established systems for acute disaster response, including disaster base hospitals and Disaster Medical Assistance Teams, the publication highlights a gap in planning for the continuity and recovery of essential healthcare services during prolonged disruption.

Drawing on the 2024 Noto Peninsula earthquake, the publication shows how prolonged isolation and disruption can affect hospitals, long-term care facilities, utilities, staffing and care for older people, with disaster-related deaths continuing well beyond the initial shock. It proposes that prefectural healthcare consolidation plans include disaster resilience impact assessments covering the entire regional care network, with a focus on maintaining essential services, redistributing functions when facilities are unavailable, and restoring care for older and care-dependent populations. The publication argues that healthcare reform in ageing societies should strengthen not only acute disaster response, but also the ability of regional care systems to withstand and recover from long-term disruption.