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🏥 | So that you can meet and watch over someone every day through “at home” [I want to meet at home at the end]

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So that I can meet and be watched over by someone every day through "at home" [I want to meet at home at the end]

If you write the contents roughly
Although I live alone, home medical care has made it possible for me to meet someone every day and live a life of being watched over.

[What I want to know at home at the end] # 47 What about patients who can start "home medical care"? → Continue reading

 Daily Gendai Healthcare

We will deliver the medical and health articles of the evening paper "Daily Gendai". From everyday health laws to the latest medical information, all articles are based on interviews with doctors and specialists.

Wikipedia related words

If there is no explanation, there is no corresponding item on Wikipedia.

在 宅 医療

在 宅 医療(Zaitai,British: home medical care) And do at homeMedicalThat. It is regarded as the third medical treatment after outpatient and hospitalization.


In a narrow sense,Palliative medicineSuch asMedical staffAt home of a patient who has difficulty going to the hospital orGeriatric facilityIt is to visit and provide medical care. In a broad sense,hospitalIt is all medical care done "outside." For example, medical treatment performed at home while continuing social life, such as taking a prescribed drug at home or going to the workplace while using injections, can be said to be home medical care. Home patients vary from highly independent to lowly independent.

Contents of home medical care

There are no special restrictions on home medical care. Typical ones areMalignant tumor(cancer),Brain disease(cerebral infarction,dementiaSuch),Plastic surgery,Respiratory diseaseAnd so on. CurrentJapan OfMedical feeStipulated inHome therapyThere are the following therapies.

The number of users of each of these therapies is increasing.

Combining home-based therapy, which is constantly managed by the patient's family, with medical care provided at the time of a visit by a medical staff, it can be said that the same treatment as in a hospital can be received at home. For exampletransfusionIn some cases, they are receiving medical treatment at home while receiving regular treatment with antibiotics.

In addition, there are various other services such as long-term care services for living at home.Medical adviceI do.
It is said that home medical care also has an aspect of "personalized medicine".

Home medical care providers and their roles

Home medical care, which was provided centrally in hospitals, is divided into roles among individual medical institutions in the region, and is centrally provided to the "patient's home", which is the "hospital room". It can be said that the scale has spread and expanded from one building to one area. Currently, the bearers are as follows.

Leader of home medical care
Home visit orHome visitDoctorManages the medical condition of home-based patients through regular and systematic medical care (mostly 2 to 4 times a month). When the condition deteriorates, he visits as needed and provides medical care.
Visiting nursingVisiting nurseMainly medical treatment and care for patients through regular and planned visits. The scope of work is very wide, but it is said that many occupations are responsible for housework assistance and mere massage, and it is not covered by work (not covered by remuneration).
Home-visit dental practiceDentistVisits home patients and provides dental care. There are also dental clinics that have facilities comparable to those of clinics in visiting clinics and can provide sufficient dental care even at home.
Visit dental hygiene guidanceDental hygienistVisits home patients and provides dental hygiene guidance. In addition to mere tooth brushing instruction, we also provide various advice and guidance to continue eating.
Visit rehabilitationphysical therapist,Occupational therapist,Speech therapistVisits home patients regularly and systematically and is necessaryリ ハ ビ リ テ ー シ ョ ンI will provide a. Stay at home, not just functional trainingQOLEmphasis on improving.
Visit drug guidancepharmacistVisits a home patientDispensingIn addition to supplying medical materials and medical materials, we also provide guidance and advice on the correct medication method for prescribed drugs. Also, organize the remaining medicineSide effectsPropose medication support methods according to the situation and individual situation of home patients, and provide feedback to doctors and other occupations. Accompany the doctor's home visit and for the prescriptionPharmacyGive feedback from a positive perspective.[1]
Home-visit nutritional guidanceNutritionistVisits home-based patients and gives advice and guidance on nutrition and diet necessary for medical treatment.

Home care leaders and training

There is a specialist system certified by the Japan Home Medical Association as training for home medical care providers. In the certified specialist examination, there is a written examinationportfolioHave an interview. In the written examPalliative careField,dementiaAsk the field of geriatrics such as[2].. In other medical professions, pharmacists support home careCertified pharmacistThere is a system,学会Certified by a written examination from those who have completed the curriculum specified by[3].

Home care providers and access

Currently, as a leader in home medical carehospital,Clinic,Dental clinic,Visiting nursing station,Dispensing pharmacyAnd so on. visitリ ハ ビ リ テ ー シ ョ ンCurrently, no independent institution has been set up for home-visit nutritional guidance, but it is included in hospitals, clinics, home-visit nursing stations, etc. All of them are located near the patient's own residence, such as the family doctor, the medical consultation room of the hospital where he / she is consulting, or the local home-visit nursing station, medical association, dentist association, orCare managerYou can find out the nearest home medical institution by making inquiries to.

Home care costs

The cost is generally cheaper than hospitalization, but higher than going outpatient.

Changes in home medical fees

Medical feeThe above home medical care was institutionalized in 1981.InsulinIntroducing a home self-injection guidance management fee. Since then, every time the medical fee is revised, the medical fee is evaluated in the field of home medical care such as home oxygen therapy guidance management fee and home self-catheterization.

1986 Ministry of Health and WelfareIn the report of the Elderly Care Planning Promotion Headquarters, "Measures for the elderly have been promoted mainly by entering facilities, but many elderly people have a desire to live with their families in the community where they are accustomed to living in old age. Since I have a strong position, I will establish a home-based service system and promote comprehensive measures in combination with facility services from the perspective of strengthening the nursing care function at home. " In the longevity social measures outline decided by the Cabinet in June of the same year, "We will expand home-based services so that necessary medical care, nursing, and long-term care can be provided in daily life centered on the home as much as possible. For this reason, by promoting comprehensive health management centered on practitioners, establishing a medical system focusing on the maintenance and promotion of social life functions such as rehabilitation, and enhancing home nursing care in collaboration with home-visit guidance by public health nurses. , We will expand home insurance and medical services in the region. ”Clarified the break from the conventional inpatient medical care. Furthermore, in the second revision of the Medical Care Act in 6, "home" was positioned as a "place for providing medical care", and in 1992.Health insurance lawIn the revision of, home medical care was positioned as "medical care benefit".

After that, in the 1998 revision of medical fees, "Bedridden elderly home-based comprehensive medical fees" and "24-hour cooperation system addition" were newly established, and in the 2006 revision, "Home care support clinic" was established as a medical fee system. It has reached the present.

Social and policy expectations for home health care

1950 About 8% of the people died at home, but with the progress of medical technology and the development of medical institutions,2008 On the contrary, about 8% of the people died in hospitals.[4].. Considering this situationMinistry of Health, Labor and WelfareIs promoting home medical care[5].. In addition, the governmentSocial hospitalizationEtc.) to keep medical costs down2003 DPC (Diagnosis group classification Comprehensive evaluation), succeeded in significantly shortening the average length of hospital stay, and increased the number of home medical care related points. 2006 Cancer Control Basic LawIs established.cancerWe are promoting the maintenance and improvement of the quality of home care for patients (home care).
2010 OfEconomist Intelligence UnitAccording to a survey by Japan, the quality of death of Japan is 23rd in the world and the 1st is Britain. Evaluation items include public awareness of end-of-life care, training for medical staff, pain medication administration status,GDPRatio of[6].


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