Global Health & Medicine 2026;8(5):389-394.

ACCESS Japan Registry: Toward a nationwide evidence platform for foreign visitors requiring emergency hospitalization in Japan—Rationale, design, and governance of a multicenter registry

Saeki S, Hinohara C, Yamada E, Minamitani K, Kawasaki R

Japan has experienced a rapid increase in inbound tourism, with a record 42,683,600 foreign visitors in 2025, a 15.8% increase from the previous year and well above the pre-pandemic peak of 31.88 million in 2019, but such short-term visitors are excluded from Japan's public health insurance system, exposing patients and institutions to substantial financial and clinical risks. Despite growing clinical and policy demand, no comprehensive national database of emergency hospitalizations among inbound foreign visitors exists. Against this background, we established the ACCESS Japan Registry (Assessment of Cross-Cultural Medical Access and Emergency & Support Systems for Foreign Patients in Japan), the first multicenter registry in Japan that is designed for nationwide expansion and that targets inbound foreign visitors who require emergency hospitalization in Japan. Foreign nationals on short-term visas who require emergency hospitalization are registered in the registry, and patient demographics, clinical data (diagnosis per the International Classification of Diseases, 10th Revision (ICD-10), length of stay, outcomes), administrative and financial data (hospitalization costs, unpaid bills), and language support information are collected via Research Electronic Data Capture (REDCap). The ACCESS Japan Registry will provide the first systematic, multicenter evidence base on emergency hospitalizations of inbound foreign visitors in Japan, informing healthcare policy, international emergency medicine, and global travel medicine research. Here we describe why such a platform is needed, how it was developed, how it is governed, and what it can and cannot deliver.

DOI: 10.35772/ghm.2026.01066

Full Text: