Sociological Comparative Study on Community Care Systems

1.在当代日本的社区中，社区照顾系统不能以同样的形式构建。因此，有必要选择比较的方法来分析这些制度. (1)在农村地区，可以看到，在乡镇建立了特色的社区照料体系。（前。（长野县的安冈村、竹志村、小川村）在这种情况下，许多为老年人提供护理服务的行为者进行合作，医疗机构领导这种合作。在这些情况下，在这些村庄的医院工作的医生高度关注社区护理，并奋进构建社区护理系统。(2)在城市地区，很难建立社区护理系统。在这些地区，提供养老服务的行为主体数量庞大，各行为主体之间的合作不容易。但是，有一个案例，其中一个私人医院领导建设社区护理系统（东京千州地区）。(3)在孤岛地区，很难建立社区护理系统。在这些地区，社区医疗最重要的问题是拯救病人。在这种情况下，医生和官员主要关心的是改善医疗条件。但也有社区居民试图建立社区护理系统的情况（冲绳县竹富町的波照间岛）。医疗部门对于建设社区保健系统非常重要。(1)医疗机构参与社区卫生服务体系是必要的。(2)医生们最好能接受这样一种观念：护理比治疗更重要。(3)一个医疗部门有可能破坏一个建立社区照顾系统的机会，但一个医疗部门也可以改变这种情况。

1. In contemporary Japanese communities, community care systems cannot be constructed in the same form. Therefore, it is necessary to select a comparative approach in order to analyze these systems.2. (1) In rural areas, it can be observed that characteristic community care systems are built in villages and towns. (Ex. Yasuoka village, Takeshi village, Ogawa village in Nagano prefecture) In these cases, a lot of actors which supply care service for the aged cooperate, and medical institutions lead this cooperation. In these cases, medical doctors who work in hospitals of these villages highly concern community care and they endeavor to construct community care systems.(2) In urban areas, it is difficult to build community care systems. In these areas, amount of actors which supply care service for the aged is very huge, so these actors cannot cooperate easily. But there is a case in which a private hospital leads construction of a community care system (Senju area in Tokyo).(3) In areas of isolated islands, it is difficult to build community care systems. In these areas, a most important issue of community medicine is to save patients. In these circumstances, medical doctors and officers are mainly interested in improvement of medical conditions. But there is a case in which residents of a community try to construct a community care system (Hateruma island in Taketomi town in Okinawa prefecture).3. A medical sector is very important for constructing community care systems.(1) It is necessary for medical institution to take part in community care systems.(2) It is desirable for medical doctors to accept a idea that care is more important than cure.(3) It is possible for a medical sector to destroy a chance to build community care system.But a medical sector also can change these circumstances.