The necessary number of healthcare beds were estimated by Secondary Healthcare Area under Regional Healthcare Concept.　However, they neither employed data of Employee Health Insurance nor estimated by diseases.　In addition, Secondary Healthcare Area was established without reasonable evidence in Fukuoka prefecture.　We evaluated the validity of Secondary Healthcare Area focused on hospitalization by ischemic heart diseases in Fukuoka prefecture with using administrative claim data of beneficiaries of Fukuoka Branch of National Health Insurance Association.　The proportion of completion had differences in each area and it suggested the necessity of reforming Secondary Healthcare Area.　We could integrate into four areas using an index of net velocity by patient movement matrix table from the residence to hospitalized place as same as previous study concerning hospitalization by cancer.　However, integrated areas were different from it probably because of emergent needs.　It suggested that current Secondary Healthcare Areas were not suitable for actual hospitalization needs.　The method is able to be employed to reform Secondary Healthcare because each prefecture needs to examine validity of them by next Medical Care Plan.

［Introduction］Switching to generic drugs during paclitaxel/carboplatin （TC） therapy increased the incidence of extravasation, while switching back to brand-name drugs decreased the incidence of adverse events in gynecologic patients receiving outpatient chemotherapy.　［Methods］The medical records of gynecologic patients who had received outpatient TC therapy between January 2013 and December 2016 （initial brand-name drug period:n=238, generic drug period:n=141, subsequent brand-name drug period:n=158） were retrospectively examined.　［Results］The incidence of extravasation increased significantly during the generic drug period （initial brand-name drug period:1.3%, generic drug period:

9.3%, subsequent brand-name drug period:1.6%;P<0.01）.　A multivariate analysis adjusted for age, number of TC therapy sessions, body mass index （BMI）, and use of generic drugs showed that the odds ratio for vascular complications associated with generic drugs was 6.8 （95% confidence interval ［CI］:4.1-11.3）.　［Conclusion］The use of generic drugs in TC therapy increases the incidence of vascular complications, such as extravasation and phlebitis.

The purpose of this study was to identify the definition of “support” by staff nurses and nurse managers, and to clarify the types of support needed by staff nurses and provided by nurse managers.　We conducted an anonymous, self-administered questionnaire among 1,224 staff nurses and 169 nurse managers in 23 general hospitals in Japan.　We analyzed 1,501 descriptions provided by staff members and 365 descriptions provided by managers.　This analysis revealed that nursing staff included some requirements for needed support that fell outside the primary roles of nursing managers.　Therefore, it is necessary for nursing staff to understand the roles assigned to nursing managers.　The study’s results indicated that the types of support needed and provided fall into three major categories:content of work, management of manpower, and attitudes of managers.