Awareness of Social Insurance, Welfare Systems, and Home Medical Care Among Rheumatologists in Japan: A Cross-Sectional Study.

Objectives: To assess rheumatologists' awareness of social insurance, welfare systems, and home medical care for rheumatoid arthritis (RA) patients in Japan.

Methods: An anonymous, web-based questionnaire was distributed to 5 128 members of the Japan College of Rheumatology between April 11-30, 2024. The survey covered demographics, knowledge of support systems, and attitudes toward home medical care.

Results: A total of 478 rheumatologists responded (response rate 9.3%). While over 80% had some understanding of the High-Cost Medical Expense Benefit and Long-Term Care Insurance systems, knowledge of the Disability Pension and long-term care facility characteristics was limited. About 73% reported facing difficulties in patient support due to insufficient knowledge. Medical Social Workers played a central role in providing patient support; however, their availability was limited in smaller clinics. Although 95.3% of respondents recognized the growing need for home medical care, only 24.5% had practical experience. Major concerns included the lack of RA expertise among physicians caring for patients living at home and challenges in medication management after care transition.

Conclusions: Despite recognizing the importance of integrating social support and medical care, significant gaps remain in rheumatologists' knowledge and engagement, especially in home care settings. Educational and systemic improvements are needed.