ASOURCE Navi

With the recent advances in medical technology and the advent of an aging society, there is an increasing need to restructure the system for providing medical services in local areas. In order to meet this need, the government has launched a policy called the "Regional Medical Initiative." In this article, we will summarize the background, aims, and functional differentiation of hospital beds of the Regional Medical Initiative.

The impact of population decline and rapid aging that Japan faces also poses serious challenges to the medical system. According to future predictions by the National Institute of Population and Social Security Research, by 2040, more than one in three people will be aged 65 or older, and medical needs are expected to change significantly as a result. To address this issue, the government launched the Regional Medical Initiative in 2014. The aim is to provide high-quality medical services that are closely tied to the community while smoothly promoting the transition from inpatient medical care to home medical care. In recent years, the oversupply of hospital beds and the uneven distribution of medical resources between regions have become serious problems, but this initiative aims to appropriately differentiate and link the functions of hospital beds in each region in light of future medical needs. It aims to provide seamless, integrated medical services so that residents can receive appropriate medical care when they need it in their own region. The philosophy of this initiative is to efficiently utilize limited medical resources and build a sustainable social security system. With an eye on 2025, when the baby boomer generation will be 75 years old or older, it is necessary to develop a planned medical system that is in line with the situation in each region. In addition, efforts to promote regional medical plans are not based on a reduction in hospital beds or consolidation or closure of hospitals, but are instead undertaken independently by each prefecture, taking into account local conditions.

The core idea of the regional medical initiative is the promotion of "functional differentiation" of medical institutions. This involves estimating the required amount for each medical function (highly acute, acute, recovery, chronic) for each ward by utilizing reports on bed functions from medical institutions, and promoting the differentiation of medical functions. First, the "highly acute" phase is responsible for providing cutting-edge, advanced medical care such as surgery, intensive care, and emergency response. We accept patients who require advanced and complex treatment such as emergency medical care, cancer, stroke, heart disease, and severe trauma, and provide prompt and thorough care. On the other hand, in the "acute" phase, when symptoms have subsided, we target patients who require intensive treatment such as infections, trauma, and follow-up after surgery, but do not require long-term hospitalization. Once the condition stabilizes, it is common for patients to be transferred to an appropriate medical institution. And in the "recovery" phase, we mainly take care of rehabilitation for patients who have completed acute treatment. We play an important role in maintaining and improving activities of daily living (ADL) and supporting their return to home and society. Finally, the "chronic phase" involves providing long-term hospitalized patients, such as those who are bedridden or suffer from dementia, who require constant medical care and nursing care, with an environment in which they can live long-term recuperating lives with peace of mind. In this way, by selecting hospital beds with the optimal functions for the patient's condition, we can provide efficient medical services without conditions.

However, there are other classifications of hospitals. There are "special function hospitals" that provide advanced cutting-edge medical care and train advanced medical personnel, and "regional medical support hospitals" that provide advanced acute and acute care in close cooperation with local medical institutions, and the division of roles among hospitals is progressing. Furthermore, in the event of a large-scale disaster, "disaster base hospitals" are positioned as hospitals that provide emergency medical care, accept patients, and function as support bases for disaster medical teams. In this way, a system to support medical care throughout the entire region is being developed.

In order to realize a regional medical initiative, it is necessary to take into consideration that the nature, management policies, and financial resources of medical institutions differ depending on the entity that established them. There are a variety of entities that establish medical institutions, including public medical institutions (national university hospitals established by the national government and municipal hospitals established by prefectures and municipalities), medical institutions established by corporations, and privately run clinics. It is important that these medical institutions appropriately divide up roles and cooperate with each other.

The Regional Medical Initiative is an initiative that aims to build a consistent system that maximizes the use of limited medical resources and enables residents to continuously receive high-quality medical services in their daily lives. It is expected to contribute to the realization of a sustainable social security system in the future while responding to the diversification of medical needs.