Long-term Care Insurance Act and Home Care.
Long-term Care Insurance Act and Home Care.
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长期护理保险法和家庭护理。
DOI：
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
S. Nagasawa
中科院分区：
文献类型：
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作者：
S. Nagasawa
2006年，厚生劳动省实施医疗体制改革，将日本的医疗保健从以医疗机构为中心的医疗保健转向“以社区为中心的医疗保健”。此举的目的是建立和加强每个社区在医疗保健和长期护理方面的合作。这背后是对当前形势的认识，即仅靠医学很难解决因老龄化而导致的退行性变化所产生的问题，而仅靠医疗很难解决这些问题。医疗保健模式从医疗模式转变为生活方式模式1，可以说是随着追求个性的一代进入老年而自然发展的。此外，以战后婴儿潮一代为代表的具有“真实生活”意识的社会对家庭护理（包括护理服务）抱有很高的期望。
作者是岩手县一关市第11代私人执业医师。我是看着祖父和母亲骑着马车和自行车出家门长大的。对我来说，拜访患者家是医疗保健不可或缺的一部分，我记得这是几十年前医生的生活方式。如今，我是一家小诊所（有床位）的负责人，从我在大学任教以来的大约 10 年里，我一直在提供探访护理。每年我都会拜访80至100名在家接受治疗的患者，我发现接受家庭治疗的患者比例逐年增加。 2013 年 3 月，我与其他 5 名医生（我们当地医学协会的成员）组成了一个团队，创建了一个增强的家庭护理支持诊所。该团队由泌尿科、皮肤科和内科各个领域的专科医生以及来自急诊医院的医生组成。这些医生在利用个人专业技能的同时，与附近的医疗机构协调提供家庭护理。
In 2006, the Ministry of Health, Labour and Welfare implemented healthcare system reforms, steering healthcare in Japan away from medical institution-centered healthcare to “community-centered healthcare.” The aim of this move is to build and strengthen cooperation within each community regarding healthcare and long-term nursing care. Behind this is recognition of the current situation whereby it is difficult for medicine alone to resolve problems stemming from regressive changes due to aging that are difficult to resolve solely through medical care. That the healthcare model has changed from a medical model to a lifestyle model1 can be said to be a natural progression as the individuality-seeking generation enters old age. Furthermore, a society conscious of “living true to oneself,” which is represented by the postwar baby-boomer generation, holds high expectations for home care, including care giving.
The author is an 11th-generation physician in private practice in Ichinoseki City, Iwate Prefecture. I grew up watching my grandfather and mother making house calls by carriage and bicycle. For me, visiting patients’ homes was an integral part of healthcare, and I recall that this is the lifestyle that physicians lead decades ago. Today I am the head of a small clinic (with beds), and for 10 or so years—since the time I was teaching at a university—I have been providing visiting care. Each year I visit between 80 and 100 patients receiving medical care at home, and it is recognized that the ratio of patients receiving home care is increasing year-on-year. In March 2013 I formed a team with 5 other physicians, members of our local medical association, to create an enhanced home care support clinic. This team comprises physicians specializing in urinology, dermatology, and various fields of internal medicine as well as a physician from an emergency hospital. While utilizing their individual specialist skills, these physicians coordinate with nearby medical institutions to provide home care.