In this paper, I examine the main issues on the reform of health and social welfare services in contemporary Japan. The most important tasks are; how to integrate health and social welfare services, how to change the current bureaucratic delivery system of the services and sectionalistic relations among professionals in both health and social welfare services.

As a means of analyzing physicians’ role cognition in respect of patients’ preferences and feelings, semi-structured interviews were conducted with 46 physicians in charge of cancer treatment in one university hospital and one cancer center. Analysis followed The KJ method, which incorporates qualitative methods of response categorization and context comparison. This study shows that the common tendencies at those two different types of institutions are as follows: 1) When making a decision about treatment plan at the point of the shift from prolonging treatment to palliative therapy, there is a contradiction between the physicians’ role cognition as professionals and their actual behavior; 2) Physicians regard their own professional communication skills as the decisive factor to grasp of patients’ preferences.

This paper discusses the theoretical trends and tasks in studies of the elderly in nursing home, through reviewing literatures of these studies in American Gerontorogy. These studies have been formed by three currents or theme, and I classified these studies into various types on the basis of that currents, clarifying the theoretical trends and tasks. Finally, I pointed out the analysis possibility of these studies from the viewpoint of five perspectives.

Through the survey of 339 geriatric hospitals which adopt the Partial Capitation Payment System, we found that the the major part of patient care was carried by careworkers and range or degree of careworkers’ jobs were different between hospitals. Also, through the multiple regression analysis, we analyzed how the careworkers’ jobs are affected by the various characteristics of hospital management.

From these results, some factors of the hospital management and of the careers or the qualifications of the careworker groups showed significant correlations with the condition of careworkers’ jobs.