Operational realities of hospitals' medical long-term care beds in Yamagata Prefecture

Abstract

The reconstruction of the medical delivery system is proceeding by many kinds of functional differentiation and cooperation, aiming at utilizing the medical resource effectively. However the number of medical long-term care beds is insufficient in Yamagata, and the acute care hospitals demand the expansion of facilities with such beds to accept their discharged patients. We conducted the research for all hospitals of care-mix or chronic-phase type in Yamagata, examining operational realities of these beds. As a result, the proportion of admissions by the reasons except medical needs was over 30%. There were also over 40% of the patients continuing hospitalization in spite of their capability of leaving the hospital. The proportion of patients having high medical dependence was relatively low and such patients were mainly accepted in acute care beds. There may be some underlying causes related to tough management situations of hospitals that create this situation. However, one of the most important factors is that patients judged to be able to leave the hospitals stay in the medical long-term care beds. To make smoother the transition of the patients, we should comprehensively plan and practice the visions incorporating the various situations of nursing facility and home care in the given area.