Intended for healthcare professionals


Influence of superstition on the date of hospital discharge and medical cost in Japan: retrospective and descriptive study

BMJ 1998; 317 doi: (Published 19 December 1998) Cite this as: BMJ 1998;317:1680
  1. Kenji Hira (ken{at}, postgraduate studenta,
  2. Tsuguya Fukui, professora,
  3. Akira Endoh, postgraduate studentb,
  4. Mahbubur Rahman, postgraduate studenta,
  5. Munetaka Maekawa, postgraduate studenta
  1. Department of General Medicine and Clinical Epidemiology, Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan,
  2. Graduate School of Human and Environmental Studies, Kyoto University
  1. Correspondence to: Dr Hira


    Objectives: To determine the influence of superstition about Taian (a lucky day)-Butsumetsu (an unlucky day) on decision to leave hospital. To estimate the costs of the effect of this superstition.

    Design: Retrospective and descriptive study.

    Setting: University hospital in Kyoto, Japan.

    Subjects: Patients who were discharged alive from Kyoto University Hospital from 1 April 1992 to 31 March 1995.

    Main outcome measures: Mean number, age, and hospital stay of patients discharged on each day of six day cycle.

    Results: The mean number, age, and hospital stay of discharged patients were highest on Taian and lowest on Butsumetsu (25.8 v 19.3 patients/day, P=0.0001; 43.9 v 41.4 years, P=0.0001; and 43.1 v 33.3 days, P=0.0001 respectively). The effect of this difference on the hospital's costs was estimated to be 7.4 million yen (£31 000).

    Conclusion: The superstition influenced the decision to leave hospital, contributing to higher medical care costs in Japan. Although hospital stays need to be kept as short as possible to minimise costs, doctors should not ignore the possible psychological effects on patients' health caused by dismissing the superstition

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