2021 年 38 巻 3 号 p. 215-220
In Setagaya, regional hospitals and medical associations cooperated in formulating the Setagaya Regional Cooperative Critical Path for Diagnosis of Dementia, and put this system into practice in 2008. At the same time Setagaya Dementia Network Study Groupe, in which we discuss the operation of path and conduct case studies and special lectures, was launched. In this critical path, a physician in a clinic refers his/her patient to a regional hospital in the critical path network, using a patient record form prepared by the clinic. The doctor who receives the referral in the network hospital examines the patient for the presence/absence of dementia, determines the underlying cause of dementia, and returns the patient to the referring doctor in the clinic with the therapeutic strategies decided upon. The patient is then followed by the referring doctor in the clinic while being given drug therapy or other necessary treatments, and is examined in the hospital regularly at intervals of about 6–12 months. The introduction of this critical path system has facilitated smooth cooperation among hospital physicians, primary care physicians and staff involved in the care of patients with dementia.
Further formulation of a system to support patients with dementia involving the whole community through cooperation among patients and their families, primary care physicians, regional hospitals, administrative authorities, and regional comprehensive support centers is awaited. Such a system would facilitate reaching the future goal of construction a community that allows people to live with peace of mind even after becoming demented.
