A rapid ageing is on goimg in Japan. The population of aged more than 65 yr old accounts for 22% and Total Fertility Rate (TFR) is 1.37 in 2008. The ageing of society means the increase of aged patients with multi-morbidity. This situation requires the development of primary care services. The Onomichi Medical Association (OMA) is a front runner for the construction of primary care model that fits for the ageing society. Based on the common awareness and sense of crisis regarding the rapidly growing percentage of the elderly population in the city, the OMA started their action in order to re-establish a reliable community. As the emergency care system is a basis of reliable community, the OMA started to establish the Onomichi Emergency Committee in 1992 and has organized the OMA Emergency system. Based on this family doctor’s network, the OMA has constructed other community health system such as the OMA method on dementia care, the OMA method on long-term care management programs, the OMA method on the end of life care, the OMA method on disease management. In this article, the authors explain an overview of OMA system.

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The care of frail elderly requires multidisciplinary approach. It has long been a important problem how to systematize the quality care management for integrated care. The Onomichi Medical Association regards the care conference as a core of quality services and establishes a very sophisticated care management system that is based on the family physician led conference system, so called “the OMA method on long-term care management programs”. Thus the percentage of having CC is more than 95%. In this paper, the authors would like to explain an overview of this excellent system.

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According to the estimation of Ministry of Health, Labour and Welfare, there will be 3.8 million of dementia elderly in Japan in 2045. It is an urgent task to prepare enough volume of quality community services for the dementia persons. It is also important to organize the flexible system which makes it possible for the dementia cases to use institutional and community services according to their condition. This requires a good care management system. Based on their quality care management system, the Onomichi Medical Association (OMA) has developed a fine-tuned care management system for dementia persons, so called the OMA method on dementia care management programs. In this article, the authors would like to explain the overview of this system.

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According to the official estimation, there will be 1.7 million of deaths per year in 2038. It will not possible to prepare the hospital volume enough to accept this volume of deaths, it is indispensible to organize the quality home care system from now. This system must respect the dignity of dying persons and make efforts to assure the precious end-of-life moment with their family. In order to overcome difficulties for continuing end-of-life care at home, clinical support is essential. The Onomichi Medical Association has developed the family doctor system based end-of-life care, so called the OMA method on end of life care management programs. In this article the authors would like to present an overview of this system.

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