Abstract
The medical records and the death certificates of the past five decades, belonging to a local general clinic in a commuters town of Yokohama city, were surveyed among the outpatient to clarify the trend in the patterns of fatal disease associated with recent changes in the social and the medical environmental factors. This study was also conducted to suggest the functions and the appropriate role of a local clinic for medical care in a community. We observed that there was a decrease in the outpatient deaths from infectious diseases, with an increase in deaths from non-infectious chronic diseases. It was also found that the average age of death had risen remarkably over the last fifty years. In recent years, deaths from non-infectious diseases are not due to cancer but mostly due to cardiovascular diseases i.e. stroke, coronary heart disease, hypertensive heart disease and others. The survey showed that there was a tendency for aged patients with cardiovascular diseases to eventually return to the doctor at the local clinic. This was true even if they had been referred to other large specialized hospitals in an acute phase or they had taken further diagnostic procedudres or treatment at other hospitals. This result indicates the important role of a local clinic in developing an appropriate medical care system, in a community, for the prevention and the control of cardiovascular diseases at present and in the future.
