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

这项研究的目的是阐明启动和发展社区护理系统所必需的因素。有三个不可或缺的因素：医生(S)、居民和市政/地方政府。研究主要在三个市进行：(1)长野县竹石村(上田市)；(2)新泻县山户镇(水田市)；(3)岐阜县库泽村(井比川镇)。研究结果如下：(1)在每个病例中，对社区卫生保健有明确想法的医生开始努力实现自己的医疗保健理念。医生作为一种医疗职业的使命对社区护理系统的建立起到了重要作用。(2)居民，特别是那些需要医疗/护理护理的人和那些希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。他们的贡献是向医生和当地政府告知和询问他们需要什么，以及他们想如何使用新的服务。(3)市政府/地方政府也通过协调医生的工作条件和居民的需求，在启动和发展这一系统方面发挥了不可或缺的作用。地方政府为实现医疗和护理专业人员之间的协作关系做出了贡献。(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.