The aim of this paper was to examine the relation between neighbourhood health care resources and the sense of security of residents. From May to July 2009 I conducted a postal survey for adults aged 20-69 living in Sendai. One thousand five hundred people were randomly chosen as subjects. Variables of neighbourhood health care resources were the distance to the nearest hospital, hospital beds, clinics per 1,000 population and dental clinics per 1,000 population. The relation between neighbourhood health care resources and the sense of security of residents was examined within a multilevel framework. The intra-class correlation coefficient was 0.255. The distance to the nearest hospital had a positive effect on the sense of security. On the other hand, clinics per 1,000 population was negatively related to the sense of security. Hospital beds and dental clinics did not have any significant effect on the sense of security. Controlled by individual characteristics and socio-economic status as covariates, the effect increased slightly. It is of potential importance for a health care system to take the perspective of the daily living area into account from the point of the sense of security of the inhabitants.

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Bar code labeling of dispensing packages (such as ampoules and vials) of injections has been made mandatory by the Ministry of Health, Labour and Welfare to prevent misidentification of medicines. We analyzed what changes were brought about in hospitals regarding adverse event prevention and work-related stress for nurses by this check system using bar codes for injections (hereafter referred to as the authentication system) and whether it was effective for risk management in healthcare.
Although it cannot be clearly said that the authentication system was effective in reducing the number of incident reports, there is a possibility that the number of incidents could be reduced by using the system correctly and accurately. In addition, it turned out that the authentication system brought about great changes in work-related stress for nurses. In particular, stresses of “psychological work load” and “subjective physical load” were improved with a significant difference before and after the introduction of the system.
Furthermore, by using the authentication system, changes and cancellations of orders can be checked just before preparing and mixing injections, allowing reduction of the discard rate of injections.
There is a possibility that the authentication system may exert a further effect on traceability and risk management in healthcare by improving the place and method of bar code labeling and the content of information.

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Benchmarking (comparison of results) by introducing a “clinical indicator (CI),” an objective quantitative indicator consisting of complex components to measure the “quality of medical care,” is a powerful method to ensure and improve the quality, regardless of the acute or chronic stage of the care. The Japan Association of Medical and Care Facilities (hereafter referred to as the association), which has continued to emphasize the necessity and importance of chronic therapy as post-acute therapy (PAT) following acute therapy, completed its own “CI of chronic therapy” consisting of “10 areas and 62 items,” which fully reflects the characteristics of chronic therapy and efforts of people involved, and by which objective third-party evaluation can be made. This CI emphasizes various functions required for chronic therapy, is clearly differentiated from the usual CIs, which deal mainly with acute therapy, and is scored with a maximum of 124. It will be used for the “certification examination for chronic therapy certified hospitals” of the association and also utilized as a tool for making the standard of chronic therapy generally known, and its validity will be verified. Thereby, it will be possible to have discussions from various points of view, such as the medical supply system and health economics.

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