Journal of the Japan Society for Healthcare Administration
Online ISSN : 2185-422X
Print ISSN : 1882-594X
ISSN-L : 1882-594X
Volume 51, Issue 1
Displaying 1-7 of 7 articles from this issue
Greetings
Prespective
Original articles
  • Masako Kanekawa, Sayuri kaneko
    Article type: Original articles
    2014 Volume 51 Issue 1 Pages 9-20
    Published: 2014
    Released on J-STAGE: April 11, 2014
    JOURNAL FREE ACCESS
    To study the influence of rehabilitation, the effect of provision of home-visit rehabilitation or day rehabilitation service or combine home-visit rehabilitation with day rehabilitation service was examined by analyzing the changes in the activities of daily living (ADL) and quality of life (QOL) in the users receiving these types of rehabilitation.
    The Functional Independence Measure (FIM) scores for self-care, transfer and locomotion improved after 6 months in all the 3 groups (home-visit rehabilitation, day rehabilitation service, or a combination of the two); in particular, the combine home-visit rehabilitation with day rehabilitation service resulted in a greater degree of improvement in the scores for self-care and locomotion.
    In addition, assessment using SF-36 suggested that all types of rehabilitation are highly likely to contribute to maintaining and preventing a reduction in the QOL, and that the functional characteristics of day rehabilitation service affect the improvement of the domain of RP (role physical). On the other hand, home-visit rehabilitation did not change the domain of RP (role physical) and reduced the domain of SF (social function). However, increased the domain of BP (body pain) and GH (general health) and improvement was observed in the largest number of domains at the home-visit rehabilitation.
    Provision of services specialized to home-visit rehabilitation is highly likely to be effective for maintaining and preventing a reduction of the QOL, while the combine home- visit rehabilitation with day rehabilitation service may more effectively increase functional independence. Accordingly, a system is required that can provide rehabilitation via a variety of programs in homecare services
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  • ——A comparison of 12- and 16-hour night shifts——
    Sanae Oriyama, Yukiko Miyakoshi, Toshio Kobayashi
    Article type: Original articles
    2014 Volume 51 Issue 1 Pages 21-31
    Published: 2014
    Released on J-STAGE: April 11, 2014
    JOURNAL FREE ACCESS
    A self-administered questionnaire survey of rest before, during and after night shifts, break times, and the advantaged and disadvantages of night shifts was conducted of 12-hour night shift workers (n=140) and 16-hour night shift workers(n=681) working in general hospitals adopting a two-shift system, to clarify the state of rest and breaks in the nurses on night shifts, factors supporting the working system, and ways of resting for recovery from fatigue. Twelve-hour nightshift workers took naps at a higher frequency and had longer nap times before night shifts than 16-hour nightshift workers, while 16-hour night shift workers reported longer sleep times during the nights before their night shifts and took naps at a higher frequency and had longer sleep times during and after the night shifts. More than 90% of nurses in both groups supported the current two-shift work system rather than the three-shift work system comprising 8-hour night shifts. The following five factors appeared to be involved in the subjects supporting 16-hour night shifts:low age, no experience of three-shift work, long nap times before night shifts, long break times during night shifts, and nap times available during night shifts. Furthermore, the results of the survey suggested that 16-hour night shift workers need a break time of 2.33 hours or more to take a nap during work.
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Research notes
  • Liu Ning, Toshiki Maeda, Takumi Nishi, Akira Babazono
    Article type: Research notes
    2014 Volume 51 Issue 1 Pages 33-39
    Published: 2014
    Released on J-STAGE: April 11, 2014
    JOURNAL FREE ACCESS
    The lengths of stay for hospitalized patients with dementia are long and have increased remarkably. However, the lengths of stay of hospitalized patients with dementia have not been quantified by types of beds or districts. The purpose of the study was to identify differences in the length of hospitalization of patients with dementia by secondary healthcare area according to types of hospital beds in Fukuoka Prefecture. We analyzed electronic medical claim data of the Fukuoka National Health Insurance Organization on hospitalized patients diagnosed with dementia from April 1, 2009 to March 31, 2010. We examined the total length of hospitalization by secondary healthcare area according to types of hospital beds including general beds, psychiatric beds and long-term care beds. Furthermore, we evaluated the relationship of the total length of hospital stay with sex, age and secondary healthcare area using multiple regression analyses. There were significant differences in the total length of hospitalization of patients with dementia by secondary healthcare area according to types of hospital beds. Among secondary healthcare areas, both psychiatric beds and long-term care beds had longer lengths of stay, although there was no significant difference in lengths of stay for general beds. Significantly longer lengths of hospitalization occurred for the Iizuka and Kitakyushu areas in psychiatric beds, and for the Iizuka, Kurume, and Keichiku areas in long-term care beds. A comprehensive district care system should be created to care for patients with dementia where they have had long lengths of hospitalization.
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  • Masafumi Yokochi, Takayoshi Terashita, Katsuhiko Ogasawara
    Article type: Research notes
    2014 Volume 51 Issue 1 Pages 41-52
    Published: 2014
    Released on J-STAGE: April 11, 2014
    JOURNAL FREE ACCESS
    Helicopter emergency medical services (HEMSs) have recently increased in Japan, and government funds have accounted for a large percentage of the operational costs. Therefore, the value of HEMSs should be assessed by economic analysis. The purpose of this study was to compare the willingness to pay (WTP) for three HEMSs in Japan using the contingent valuation method (CVM). The investigated targets were HEMS operation areas in central Hokkaido, northern Hokkaido, and northern Chiba. In addition, each area was divided into two groups:a short-range group (a circle within 30 km from the base hospital) and a long-range group (the circumference of a circle within 30-70 km from the base hospital). Participants were recruited from residents living in each operation area. Through an internet-based questionnaire, the participants were asked how much they would pay to continue HEMS in their area if it was abolished. A double-bound dichotomous choice was used as the elicitation method. The median WTP for each area was estimated by the logit model. WTP in central Hokkaido, northern Hokkaido, and northern Chiba resulted in 3,393; 6,696; and 2,399 yen/year, which were significantly different results. Moreover, a significant difference between the short- and long-range groups was revealed for northern Hokkaido. These results show that residents have high expectations for HEMS in depopulated areas.
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