Objective
The purpose of this study is to evaluate the differences in the reasons for visits to a Tokyo hospital before and after the changing of the name of the outpatient service from “internal medicine” to “general practice.”
Methods
The participants in this study were outpatients who visited the internal medicine department from September to October, 2006, and the general practice department from September to October in 2008, for their first medical examination at a hospital in Tokyo.
We encoded the reasons for the hospital visits using ICPC-2 (International Classification of Primary Care-2), and counted the number of reasons for each outpatient.
Results
In the internal medicine service, there were 362 outpatients participants (193 men and 169 women) with an average age of 48.6 years. In the general practice service, the participants consisted of 376 outpatients (206 men and 170 women) with an average age of 50.5 years. The difference between the total number of reasons for visits to the general practice service (1.7 ± 0.9 per visit) and to the internal medicine service (1.5 ± 0.8 per visit) was statistically significant. However, no significant differences were found between the two in terms of the proportion of the frequency for each category of reasons.
Conclusion
This study found that the changing of the name of the outpatient service from “internal medicine” to “general practice” led to a slight but statistically significant increase in the total number of reasons per visit. However, this change had no effect on the frequency for each category of reasons as a proportion of the total.

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Purposes
The purposes of this study were to analyze the relationship between the discharge destinations of patients with cerebrovascular diseases (CVD) in our convalescent rehabilitation ward and their levels of activities of daily living (ADL), and also to consider the factors causing those patients difficulties upon discharge.
Methods
The subjects were 114 CVD patients in our Convalescent Rehabilitation Ward.
The investigation was conducted to examine their ADL score, both at hospitalization and at discharge, and to analyze the relationship between changes in their ADL scores and their discharge destinations.
Discussion
It was suggested that reduction of the ADL score from above 8 points at hospitalization, to less than 4 at discharge, contributed to improvement of the rate of discharge to the patients' own homes, and that four items in the ADL assessment scale, such as ‘transfer’, ‘ability to communicate’, ‘locomotion’ and ‘oral care’, had an effect on their discharge destinations.

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Purpose
Long-term elderly care of the elderly (Jap. “Ro-ro Kaigo”) is a serious problem in Japan. The purpose of this study is to reveal the current state of Ro-ro Kaigo and to evaluate the factors affecting the burden on elderly caregivers.
Method
Ninety-three households of elderly subjects participated in this study. We conducted semi-structured interviews concerning the life styles of caregivers, the burden on caregivers and the condition of elderly subjects requiring long-term care.
Results
Eighty percent or more of the caregivers were spouses, and about 40 percent of the households were not supported by family members living separately.
Moreover, the burden of care borne by the caregivers was correlated with "hours spent daily providing care", "ADL of elderly requiring long-term care" (p<0.001), "hours of sleep" (p<0.01), "subjective feeling of wellbeing", "support from family living separately", and "behavioral disorders of dementia" (p<0.05).
Conclusion
These data suggest that supporting "health promotion", "reduction of hours of caregiving", "reduction of amount of assistance with toilet activity of care recipients", and "securing enough hours of sleep" were important for maintaining home care in Ro-ro kaigo.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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