Fukaura Hikoaki
Iwate Medical University, Neurology.
Rinsho Shinkeigaku. 2010 Nov;50(11):1069-72.
What is required to provide high quality medical service to anybody, anytime and anywhere? We have investigated health care in neurology as provided by national health insurance in Aomori, Akita and Iwate prefectures compared to health care in Tokyo. We have conducted hearing surveillance to patients and doctors. Most of the patients have to drive to hospital for more than 100 kms as there is no licensed neurologist in their neighborhood and public transportation is poor. There are only a few medical facilities that can satisfy their needs even in prefectural cities. Neurologists who work alone at general hospitals face difficulties as they cannot consult with other neurologist about diagnosis and treatment and have rare opportunity to attend academic conferences. A licensed neurologist at northern Tohoku district has to be in charge of a half of Tokyo 23 districts area and twice as many people as Tokyo. We have concluded that medical divide due to the more or less of quantity of selection exists between northern Tohoku and Tokyo. How do we cure this medical divide? Creating a new framework of patients transporting system, increasing the number of doctors who work at general hospitals and opening satellite clinics at regional towns should be considered.
要随时随地为任何人提供高质量的医疗服务需要什么？我们调查了青森县、秋田县和岩手县国民健康保险提供的神经内科医疗服务，并与东京的医疗服务进行了比较。我们对患者和医生进行了听力监测。由于附近没有执业神经科医生且公共交通不便，大多数患者不得不驱车100多公里前往医院。即使在县级城市，也只有少数医疗设施能够满足他们的需求。在综合医院独自工作的神经科医生面临困难，因为他们无法就诊断和治疗与其他神经科医生进行会诊，而且参加学术会议的机会很少。东北地区北部的一名执业神经科医生必须负责东京23个区一半的区域，人数是东京的两倍。我们得出结论，东北地区北部和东京之间存在因选择数量或多或少而导致的医疗差距。我们如何消除这种医疗差距？应该考虑创建一个新的患者转运系统框架，增加在综合医院工作的医生数量，并在区域城镇开设卫星诊所。
