(FY2025 Financial Results Flash Report) Our thoughts on the report that 83% of municipal hospitals are in the red (down from 86% the previous year).

On July 16, 2026, the Japan Municipal Hospital Association released the FY2025 Financial Results Survey (Flash Report).

https://www.jmha.or.jp/contentsdata/keiei/20260716_r7kessan_houkoku.pdf

Seeing those numbers, I felt a great sense of crisis.

After analyzing the 485 hospitals that provided valid responses out of 835 member hospitals, 404 hospitals (83%) were in the red on an ordinary basis.

It was 86% the previous fiscal year, so has it improved? Even so, more than 4 out of 5 hospitals are still in the red.

Furthermore, for all 485 hospitals combined:

• Medical revenue: 3.7535 trillion yen

• Medical expenses: 4.2127 trillion yen

• Medical loss: 459.2 billion yen

This was a very severe result.

These figures indicate that hospital management is still in a critical phase.

Hospital management has entered a new era

In the past,

"Increasing hospital beds," "increasing medical departments," and "increasing the number of patients"

were the growth models for hospitals.

However, in a Japan with a declining population and a shrinking birthrate combined with an aging society, that approach alone is no longer sustainable.

Medical demand varies by region, and it is no longer an era where all medical institutions aim for the same direction.

I believe this flash report shows that reality through the numbers.

The path we have chosen is to "refine our role"

Fukuoka Spine Clinic is a clinic with 19 inpatient beds.

We are by no means a large-scale hospital.

What we aimed for was:

• To specialize in spinal disorders

• To actively incorporate minimally invasive surgery

• To start rehabilitation from the day after surgery

• To provide consistent care, including osteoporosis treatment

• To collaborate with local acute care hospitals and clinics

These were our goals.

Instead of "making the hospital bigger,"

we chose to clarify the role we play in the community.

We chose that direction.

We have also been fortunate.

Of course, I do not believe we are where we are today solely through our own efforts.

In the Fukuoka metropolitan area, there were not many medical institutions specializing in spinal disorders.

Therefore,

"I want to receive specialized treatment"

there was a need in the community for this.

We were blessed that those needs aligned with our expertise.

In other words,

the role the community required and the value we could provide overlapped.

We believe this is what has led to the present.

Specialization is not the only correct answer.

Please do not misunderstand me here; I do not believe that our approach applies to every medical institution in the country.

Hospitals responsible for emergency life-saving care.

Hospitals responsible for perinatal care.

Hospitals supporting remote medical care.

University hospitals.

Each plays a different role.

That is why what is important is,

to discern 'what is being asked of us by the community.'

Refining that role will likely become increasingly important in future medical management.

What I want to convey at the Clinical Neurosurgery Society in August

At the Japan Clinical Neurosurgery Society to be held in Osaka next month, we plan to present our efforts to date.

The theme of my presentation is,
"The Utility of a Specialized Minimally Invasive Spine Surgery Model in Clinics with Inpatient Beds: Surgical Trends and Management Considerations Over Two Years Since Opening"
is.

This is by no means a story about how a 'spine specialty clinic succeeded.'

As hospital management becomes increasingly difficult nationwide,

by clarifying roles in accordance with regional medical needs,

increasing specialization,

and combining minimally invasive medicine with team-based care,

what kind of medical service provision system have we built?

I would like to introduce this as one practical example.

Conclusion

Looking at this financial flash report,

I felt something once again.

That is,

“The coming era will be one where it is not the size of the hospital that matters, but the role it plays in the community.”

That is what I mean.

I do not believe our approach is the only correct answer.

However,

identifying the role required by the community and evolving to match that role,

is that not the form required of medical institutions from now on?

This flash report was content that made me think about that once again.

Sources

• Japan Hospital Association of Local Governments, "FY2025 Financial Status Survey (Flash Report)" published (July 16, 2026)

• Japan Hospital Association of Local Governments, "Hospital Management Analysis Survey" statistical data

• WIC Health Policy Information Center, "83% of municipal hospitals have recurring deficits, an improvement of 6 points from the previous fiscal year" (July 16, 2026)

• CBnews, "FY2025 Financial Results Flash Report for Municipal Hospitals" (July 17, 2026)