The study aim is to examine the effect of non-familial support for elderly persons on their refraining from medical care. We used survey data collected in a small, semi-mountainous area of Hakusan in Mie prefecture, Japan (response rate = 91.7%). Community officials visited respondents' houses to distribute the questionnaires on September 1, 2012; these were collected by September 20, 2012. Self-reported refraining from required medical care was used as a dependent variable for the 1341 elderly males and females aged 60 or over who participated. An endogeneity test of three factors of non-familial support―family doctor, close neighbors, and close friends other than neighbors―was undertaken. The results showed that these factors were not endogenous.
The frequencies of self-reported refraining from medical care were as follows: often (4.0%), sometimes (13.6%), seldom (32.7%), and never (49.7%). The ordered probit estimation revealed that among the factors of non-familial support, having a home doctor and having close friends other than neighbors were negatively associated with the frequency of refraining from medical care. Conversely, having close neighbors was not statistically associated with refraining from medical care. These results suggest that non-familial support can prevent elderly people from refraining from medical care. Local governments could ensure that elderly people have a family doctor and help them to create a supportive, non-familial network.

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The objective of this study was to conduct a literature review comparing oral brand-name and generic drugs used for arrhythmia and to summarize the relevant clinical evidence.
Using the PubMed and Ichushi databases, we searched for articles comparing brand-name and generic drugs and categorized them according to the Vaughan Williams classification. For assessment, we divided the articles into affirmative and unfavorable groups according to the authors' positions concerning generic substitution. In addition, we evaluated the evidence levels of the articles.
Twenty articles were reviewed in this study, of which 14 were classified as affirmative and six as unfavorable. Of the affirmative articles, one was graded as evidence level I and six as evidence level II. Among the unfavorable articles, one was graded as evidence level II, four as evidence level V, and one as evidence level VI; no articles were graded as evidence level I. The affirmative articles included an evidence level I study report on drugs used for cardiovascular disease such as β-blockers; this evidence level demonstrates a significantly high level for articles pertaining to clinical efficacy and safety. Unfavorable articles tended to have lower evidence level than affirmative articles because many of these articles were case reports with a small number of subjects or descriptive studies, without details regarding the study methods and patients.

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