[in Japanese]

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COVID-19 pandemic has significantly changed the way people visit medical institutions. In this study, in order to investigate the impact of COVID-19 on medical institutions, we examined the impact on consultation before and after the outbreak of COVID-19.Both inpatients and outpatients decreased significantly immediately after COVID-19, and although there is a trend of recovery thereafter, they have not yet fully recovered. Compared to before COVID-19, the number of patients has decreased and has not yet recovered. The factors behind the decrease in patients are as follows. Infection control measures for patients led to the prevention of diseases other than COVID-19.Medical institutions were concerned about the spread of COVID-19, so they secured beds for accepting COVID-19 patients and kept the number of other patients to a minimum. Although the number of consultations decreased significantly compared with COVID-19 patients in some clinical areas, the number of deaths did not decrease. This result suggests that in Japan, the collapse of the medical system did not occur even during the epidemic, and that the necessary medical services were maintained. In other words, it shows that necessary medical consultation was secured even during the COVID-19 pandemic. If we can obtain knowledge that the quality of medical care has been maintained during this period, it can be considered that the current medical care status has been optimized for the original medical function. Considering the severe financial situation of social security, it is possible that analysis from this perspective will be conducted in the future. Therefore, Saiseikai needs to raise its interest in the quality of medical care more than ever and carry out activities to improve it. In terms of the quality of medical care, it is important to be able to provide necessary medical care in an emergency like this one, and this point also needs to be examined based on this experience.

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A total of 14,173 patients with COVID-19 were hospitalized to Saiseikai hospitals during the period of February 2020 to March 2022, and 544 patients (3.8%) died during hospitalization. Multivariate logistic regression analysis with in-hospital death as dependent variable identified male sex, older age, and didderent variant dominant period as independent predictors of in-hospital death. After controlling for these predictors, cor pulmonale and pulmonary circulation disorder, valvular heart disease, chronic kidney disease, and liver disease are found to be significantly associated with in-hospital mortality risk. These findings are useful to assess the prognosis of COD-19 patients at admission.

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　This study analyzes free-response statements regarding the response to new coronavirus infection (COVID-19) in a survey conducted in November 2021 to Saiseikai's home service offices regarding comprehensive community care (cooperation between medical care and welfare).
　　The analysis of free descriptions from home service providers using text mining revealed issues that arose from the coronary disaster and how each office responded to them, such as dealing with users and their families, infection control measures based on business continuity as an organization, and cooperation in the community. It was also suggested that collaboration on a routine basis is also important. It became clear that each business site was taking steps to resolve issues, taking into consideration the relationship with neighboring facilities and the needs of the community.
　　In the future, we would like to further visualize the movement of staff and specific innovations in collaboration through both questionnaire and interview surveys, including collaboration in the community and development of social resources in the Corona Disaster.

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Saiseikai Research Institute Bulletin
Vol.3
＜Special issue of COVID-19＞
December 28th, 2022

Publisher
Social Welfare Organization Saiseikai Imperial Gift Foundation
Director
Shigeru Sumitani

Editor
Saiseikai Research Institute of Health Care and Welfare

Mita-Kokusai Bld.21st floor, 1-4-28, Mita, Minato, Tokyo,
108-0073, Japan

TEL: +81-3-3454-3315
FAX: +81-3-3454-5022
URL: http://soken.saiseikai.or.jp/

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