The target number of long-term care hospital beds in health care cost control plans of prefectures largely exceeded the expectation of the Ministry of Health, Labour and Welfare, and the current number of long-term care hospital beds will be mostly maintained until the end of fiscal 2012, the target fiscal year. The result of a survey of the decision processes for the health care cost control plans revealed that one of the reasons for this is an effect of the expansion of the local governments' discretion with the progress of decentralization.
Concretely, although the Ministry of Health, Labour and Welfare strictly directed local governments to follow the reference standard, 5 out of the 6 surveyed prefectures used calculation methods of long-term care hospital beds number that were different from the calculation formula of the reference standard and of these, 4 prefectures had numbers that greatly exceeded the target calculated by the government.
This result indicates that the long-term care hospital beds control policy of the government actually “changed”; that is “changed” from the “target numbers assigned by the government” using a uniform calculation method according to therapeutic divisions, to the establishment of “independent and diverse target numbers” based on the actual conditions of local areas.

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The objective of this study is to survey circumstances in different facilities regarding dysphagia diet needs and dysphagia screening systems, from the point of view of dysphagia care management.
A questionnaire survey was performed by registered dietitians in hospitals and long-term care insurance facilities.
Survey results showed that compared to hospitals dysphagia diet needs were greater in long-term care health facilities for the elderly and long-term care welfare facilities for the elderly.
Compared to other facilities, long-term care welfare facilities had the greatest dysphagia diet needs, but also a trend toward least apparent dysphagia screening system.
The presence of a dysphagia screening system indicated screening performed by a medical doctor or a speech therapist, and modifications of and recommendations regarding meals.
To ensure dysphagia screening systems in facilities will require the placement of staff with specialist knowledge relating to dysphagia care, and a standardized method of dysphagia screening.

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As a preliminary investigation to determine the appropriate number and distribution of senior anesthesiology residents, a questionnaire survey was conducted among professors of anesthesiology in national universities, concerning the appropriate number, distribution and present situation in their prefectures and the education programs being currently carried out. The ratio of the number of senior anesthesiology residents to the total number of senior residents that is considered to be appropriate is 8.7%, on average, and the actual ratios were almost similar. On the other hand, the ratio of the actual number of senior anesthesiology residents to the number considered to be appropriate was approximately 60%, reflecting the shortage of the absolute number in the present situation. As for the maldistribution among local areas, the adequacy rate was high in Tokyo, Kyushu and Kansai, whereas it was low in Hokkaido/Tohoku, Kanto/Koshinetsu and Chugoku/Shikoku. As for the maldistribution among hospitals, the adequacy rate was extremely low in general hospitals in Hokkaido/Tohoku, whereas it was low in university hospitals and high in general hospitals in Kansai and Chugoku/Shikoku. It was considered that measures, such as further increase in the number of senior anesthesiology residents and strengthening of cooperation programs, are required in local areas and hospital types where the adequacy rate is low.

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