Institutional care will remain a significant element in services for the elderly. The chronic hospital is lack of residential care, and Nursing-home is insufficient medical care. The patient in continuing care admitted to a chronic hospital will give up certain rights to get better health and the person in nursing-home ill give up to get a better medical treatment. Good practice in the long term continuing care is increasingly putting emphasis on producing a home-like atmosphere under the safety and health care. Linked services with the chronic hospital and the nursing-home are important to the support for the community care for the elderly.

Planning and evaluation for providing care to residents in nursing homes are discussed in terms of types of care provided and dimensions on which planning and evaluation should be conducted. Four types of care are: basic care, medical and nursing care, personal care, and psychosocial care. Four dimensions of planning and evaluation include input, process, output and efficiency. Issues and recommendation for future implementation of planning and evaluation are discussed.

Geriatric Intermediate Care Facilities (GICFs) have been established to help the hospitalized elderly return home. Users of the GICFs are elders who do not need hospitalization, but are mentally or physically impaired. Rather than providing unnecessary medical services, GICFs emphasize nursing care and rehabilitation so that users can manage their daily tasks independently. Contrary to the initial expectation, only half of the users came back home and quarter stayed at GICFs for more than one year. Evaluating users’ physical, mental, and socioeconomical conditions at an early stage of admission to a GICF may lead us to prediction whether a user can be discharged to his/her home or remain at the GICF for long time.

In October 1990, we conducted a comparative care needs study of long-term care facilities for the aged. The subjects consisted of 1,262 inmates in 12 facilities: 314 in three general hospitals (average age: 78.5); 391 in three hospitals for the aged (80.8); 410 in four skilled nursing homes (81.2); 147 in two special nursing homes (81.3). Result of the survey, (1)among the ADL, “mobility” with whole assistance was 39.8% of the subjects in general hospitals, 57.5% in hospitals for the aged, 22.7% in skilled nursing homes, and 36.7% in special nursing homes. (2)The ratio of “seriously” and “very seriously” demented subjects, as judged according to KARASAWA's scale, was 16.9% in general hospitals, 27.9% in hospitals for the aged, 16.3% in skilled nursing homes, and 22.4% in special nursing homes.

Within a larger framework of institutional care for the aged, this paper discusses private retirement and care facilities in Japan from the standpoint of planning and evaluation. The phenomenon is still new; in 1991, 228 such facilities were reported with the total number of 21,825 residents.

After discussing the current situation in terms of the number and characteristics of operating organizations, a dominant operating system, and historical backgrounds for the past 30 years, the paper discusses some inherent problems and possibilities pertinent to retirement and care facilities run by the private sector.

To examine resarch characteristics and theoretical tasks of health sociological approach in health, medical and nursing issues, this paper reviewed master and doctoral theses published by department of Health Sociology, The University of Tokyo during these 25 years. Although a lot of active researches have been done, several theoretical tasks and topics to be studied remains yet.

Medical sociology has been discussed that has serious dilemma between the two research styles; ‘sociology of medicine’ and ‘sociology in medicine’. The dilemma has influenced on the research orientation in this field and produced some biases in favor of medical concern. Breaking through the dilemma, clinical sociology is considered as one of the most promising approaches. It is characterized by the practical application of sociological theories and concepts to clinical problem solving. In this paper, the history of clinical sociology in the U.S. are reviewed, and its methods and implications for medical sociology are discussed.

Sociology of medicine or “Medical Sociology” is said to have been severed from the mother discipline, and characteristically “a-theoretical” in nature. What is the precise meaning of this statement? In what sense and to what degree is the subspeciality said to be ”a-theoretical”? On what grounds to be theoretical could be reasonable recommendations, and what are the conditions and strategies favorable for productive intersection? These are the main questions this article try to investigate.

This paper will try to clarify what hospital managerial strategy and organizational design are desirable in this coming super-aged society. In this research, decision analysis―in particular, multi-attribute utility analysis―is used for planning strategy and designing organization in hospitals.

In conclusion, hospital organizations are fairly expected to make managerial strategy and organizational design changed from ‘closed system’ to ‘open system’ or from ‘function-oriented’ to ‘product-oriented (disease unit)’ while holding paradoxical stance in order to survive in super-aged society.

In this study, acceptance of attitude for a terminal care by 163 medical students and 185 nursing students was compared in regards with the choice of prolongation of life by medical care or hospice care at the terminal illness with cancer. It is concluded 107 male medical students were more inclined to prefer continuing treatment to prolongation of life by medical care rather than giving hospice care compared with female medical students and student nurses.

This paper reports a questionnaire survey of contemporary Japanese medical practitioners in 1993 and its preliminary analysis of the survey results.

Questionnaire surveys of medical doctors in this country have rarely been conducted by Japanese medical sociologists, partly due to the fact that doctors are usually unwilling to cooperate.

The 1993 survey, which is the third survey by Nakano(the first being in 1972, the second, in 1982), was made possible thanks to the grant from the Ministry of Educaion and the thoughtful cooperation of two local medical associations in K city and N city.

Going to see a doctor is one of the cooping behaviors when we feel sick or ill. In this article, factors affecting a dicision whether they go to see a doctor or not, and why they choose their doctor are mentioned.

In Japan, because the referral system does not work well patients often change their doctors without a referral. Doctors’ insufficient explanation about disease and doctors’ attitude ignoring patients’ idea for disease are influential factors for patients to change their doctors. Therefore, it is important to investigate patients’ help seeking behavior in medical care from the standpoint of patients besides administrators. In this article, reviewing former researches, other effective ways to investigate patients’ help seeking behavior in medical care are mentioned.