Roles and Tasks of Doctor(s) and Inhabitants in making a Community Care System

本研究的目的是厘清启动和发展社区照护系统的必要因素。有三个不可或缺的因素：医生、居民和市政当局/地方政府。这项研究主要在三个城市进行。(1)长野县武史村（上田市）；(2)新泻县大和镇（南宫沼市）；(3)岐阜县久泽村（岩川镇）。(1)在每一个案例中，有明确社区卫生理念的医生都开始努力在医疗活动中实现自己的理念。医生使命作为医学职业的重要组成部分，在制度上发挥了重要作用。(2)居民，特别是那些需要医疗/护理的人，以及那些被期望作为家庭成员照顾他们的人，是建立社区护理系统的下一个重要因素。他们的贡献是告诉并询问他们需要什么，以及他们想如何使用医生和当地政府的新服务。(3)通过协调医生的工作条件和居民的需求，市政府/地方政府在启动和发展该系统方面也发挥了不可或缺的作用。当地政府为实现医疗和护理专业人员之间的合作关系做出了贡献。(4)社区护理系统将在每个地区变得重要。

The purpose of the research is to clarify necessary factors to start and develop a community care system. There are three indispensable factors : doctor(s), inhabitants and municipality / local government. The research has been done mainly in thee municipalities.(1) Takeshi Village (Ueda City), Nagano Prefecture(2) Yamato Town (Minamiuonuma City), Niigata Prefecture(3) Kuze Village (Ibigawa Town), Gifu PrefectureThere are four findings.(1) In every case, doctors with a definite idea of community health care began to make efforts in order to realize their own idea in their medical care activities. Doctors' mission as a medical profession has played an important role to make the system.(2) Inhabitants, especially those who need medical / nursing care and those who are expected to take care of them as family members, are the next important factor to make the community care system. Their contribution is to tell and ask what they need and how they want to use the new services both to doctors and the local government.(3) Municipality / local government has also played an indispensable role to start and develop the system, by coordinating doctors working conditions with inhabitants' needs. The local government has contributed to realize a collaborative relationship between medical and nursing professionals.(4) Community care systems will become important in every region.