Tokyo has some special aspects in comparison with the other areas in Japan. As of February 1st, 2009, Tokyo had a population of 12,909,940, and about the 2/3 lives in Tokyo 23 wards. In this area, the number of ambulance transport, especially for elderly patients is increasing. But the number of emergency hospitals is decreasing sharply year by year. Under such a situation, the result of fact-finding report about medical care function in Tokyo metropolitan area demonstrated that some hospitals for acute illness in Tokyo had their own networks including cooperation hospital to smoothly transfer patients. Our department has already built the big wide cooperation, as the board-certificated physiatrists belonging to our department were posted in the hospital of not only in Tokyo 23 wards but also in six prefectures around Tokyo. Revising this previously-built network, we were able to make a new network, MSN, which covers broader area than the previous one. Although the form for MSN is very easy to complete, it contains some international evaluation scales such as Barthel Index, NIHSS and ABMS. Now the number of hospitals participating MNS exceeded 60. We aim to strengthen cooperation with rehabilitation hospitals dealing with stroke patients in chronic phase.
