Fukuda Hideki, Shinsyo Fumiaki, Takatorige Toshio, Nakanishi Noriyuki, Tatara Kozo
Department of Social and Environmental Health, Graduate School of Medicine, Osaka University.
Nihon Koshu Eisei Zasshi. 2004 Mar;51(3):181-9.
All Japanese municipal governments have a responsibility to conduct a medical examination for their residents aged 40 or more under the Health Services for the Elderly Act since 1984. According to the results of the medical examination, municipal governments should give appropriate follow up services to all users. The objective of this study was to find the factors promoting follow up services after medical examinations conducted by municipal governments.
Mailed questionnaire surveys on follow up services after medical examination were sent out to all 3,255 municipal governments in Japan. The 2,447 municipal governments that answered all items on the questionnaire were enrolled in this study. Follow-up services by municipal government for persons with abnormal findings at medical examinations included "Suggestion to have a more detailed examination", "Confirmation of having had a detailed examination", "Individual health consultation", and "Home visit for medical guidance". These follow-up services were analysed in terms of the number of public health nurses per population and whether a continuous data set was maintained for medical examinations.
Follow-up services were conducted more frequently in municipalities that maintained continuous data sets of medical examination than those that did not. They were also carried out more frequently in municipalities with higher numbers of health visitors per population than in those with lower numbers. The percentage of municipal governments that maintained continuous data of medical examinations was higher among those that conducted group medical examinations than those that conducted individual medical examinations at local medical facilities.
Follow-up services after medical examinations by municipal governments showed a significant relationship with maintenance of a continuous data set of medical examinations and the number of public health nurses.
自1984年起，根据《老年人保健服务法》，日本所有市政府都有责任为40岁及以上居民进行体检。根据体检结果，市政府应为所有体检者提供适当的后续服务。本研究的目的是找出促进市政府在体检后提供后续服务的因素。
向日本所有3255个市政府发送了关于体检后后续服务的邮寄问卷调查。对问卷所有项目都做出回答的2447个市政府纳入本研究。市政府对体检结果异常者的后续服务包括“建议进行更详细的检查”、“确认是否已进行详细检查”、“个人健康咨询”以及“上门医疗指导”。根据每人口公共卫生护士数量以及是否维持体检连续数据集对这些后续服务进行分析。
维持体检连续数据集的市政府比未维持的市政府更频繁地开展后续服务。每人口健康访视员数量较多的市政府比数量较少的市政府更频繁地开展后续服务。在当地医疗机构进行集体体检的市政府中，维持体检连续数据的百分比高于进行个人体检的市政府。
市政府体检后的后续服务与维持体检连续数据集以及公共卫生护士数量存在显著关系。
