The aim of this analysis was to specify factors that related to the differences in the states of drug management guidance jobs among hospitals using the administrative data of multiple institutions. We targeted 94 hospitals throughout Japan and used the Diagnosis Procedure Combination (DPC) data and results of a questionnaire survey. In this analysis, the state of implementation of drug management guidance jobs was expressed as an index based on the state of estimation of the fees for drug management guidance, which was converted to a value for each patient and each pharmacist, and used as the objective variable. Other jobs such as handling of sterile drugs or management of fee for specific therapeutic drug monitoring, years of experience, states of introduction of IT systems, and bed occupation rate, etc., were used as the explanatory variables, and multiple linear regression analysis was performed. The results revealed that there was a large dispersion among hospitals in the states of implementation of drug management guidance jobs and this dispersion was related to the number of hospitalized patients per pharmacist, number of outpatient medicines dispensing, and other jobs related to hospitalization. It is considered above findings will be useful when optimizing resource distribution and job designing of pharmacists, however as the coefficient of determination determined from the multiple linear regression analysis was about 0.25, the results also suggested dispersion in the performance of the pharmacy departments.

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To understand how Falls/Slips (Falls) occurred at hospitals, the epidemiological aspects were explored by using incident reporting and administrative profiling data. There were 7,717 incident reports collected between 2007 and 2009 FY at a teaching hospital in Japan. They included 1,764 reports for Falls and Falls rate (FR) was 1.84/1,000 patient-days (1,000 pt･dys). Of 1,764 cases for Falls, Mean age±SD (standard deviation) were 66.9±19.2 y.o. for male (950 cases) and 69.9±19.2 y.o. for female (814 cases). FRs were 2.06 for male and 1.87/1,000 pt･dys for female.
　　FR in 70's (555 cases) was 2.82/1,000 pt･dys and the highest by age. With clinical services, FR of orthopedics was 1.14 and FR of cardiovascular and respiratory medicine were 1.97. FRs at internal medical services was higher than those at surgical services.
　　Furthermore, with respect to duration between admission and Falls, FR for the second day after admission was 0.16/1,000 pt･dys （118 cases） and the highest, 0.12 （84 cases） for the third day after admission, and 0.11 （78 cases） for the date of admission, and FR was getting lower day by day.　The mean of duration was 12.4 days, and the cumulative percentage exceeded 50% on the eleventh day after admission.
　　Since the epidemiological characteristics of Falls are explored from the viewpoint of FR, appropriate and effective actions for patient safety are needed.

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The integration and restructuring of municipal hospitals in Okitama district of Yamagata centered around Okitama Public General Hospital is now recognized as the most successful and pioneering examples of integration and restructuring of municipal hospitals today. In this study, we conducted an ex-post-facto verification of the integration and restructuring, by statistically clarifying the evaluation by the demand side, which we believe has not yet been done.
From the results, it became clear that the medical care provision after the integration to Okitama Public General Hospital, while sacrificing the access a little, was viewed favorably by the local residents. In addition, even in respect of access, no significant problems have been encountered after the integration. Furthermore, there are a lot of opinions calling for enrichment of advanced and specialized medical care at Okitama Public General Hospital, although more residents are calling for enrichment or expansion of facilities for long-term care. Because anxiety over chronic diseases that cannot be completely cured by acute-care hospitals alone is also high, the functional differentiation between Okitama Public General Hospital and the satellite hospitals seems to fit the needs of the residents.
Based on these findings, we confirmed that the integration and restructuring of municipal hospitals centered around Okitama Public General Hospital is being viewed favorably, in general, even from the demand side, namely, the local residents.

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The purpose of this study was to identify the characteristics of the clients of the visiting nurse (VN) service who make up a large proportion of direct / indirect tasks, and to describe the details of these tasks. The subjects in this study were 95 VN service clients from 19 VN agencies. We conducted a self-recorded time study to investigate how much time the VN station staff spent on indirect/direct tasks.
　　The clients who held a smaller proportion of indirect tasks had serious care needs with regard to long-term care insurance or medical care insurance without dementia, or other psychiatric disorders, as a primary disorder;the clients who made up a large proportion of the indirect tasks had dementia, or other psychiatric disorders, as a primary disorder. To provide efficient VN services, it is necessary to shorten the labor time by utilizing nurse assistants or developing efficient logistic systems. For the latter type of clients, it is necessary to discuss whether the task of responding to calls by the former type of clients and their families can be delegated to a specific “call center.”

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