title: [Medical care and long-term care insurance and clinical practice guideline for neurological disorders].
abstract: Society in 21st century is a global community, and undergoes a paradigm shift to a new value. This is about the significance of clinical practice guideline for neurological disorders as a new paradigm in information technology society and global community. Medical care is required to be "safer, more effective, more efficient and more transparent" in 21st century. In order to improve the quality of medical care, not only the improvement of the quality in manpower but also the betterment of the response to patients based on proper balance between quality and efficiency of medicine is required and clinical practice guideline for patients and medical doctors should be actively utilized. Guidelines are socially positioned following regulations, directives and recommendations and it is not restriction upon practitioner and patient decisions about appropriate health care. In the definitions of Institute of Medicine and Medline-MeSH, a word "assist" is used and it is said that guidelines are "means to realize EBM assisting decision making" for medical doctors to expertise their specialties. It has a significant meaning in connection with doctors' discretion. When clinical practice guidelines clarify the intended purpose and are applied as suggestion instead of obligation, they would not invade doctors' discretion.
authors.affiliation: Department of Neurology, Kawatana National Hospital.
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Shibuya
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards*; D017598:Efficiency, Organizational; D019317:Evidence-Based Medicine; D006801:Humans; D007255:Information Services; D007353:Insurance, Long-Term Care; D009422:Nervous System Diseases / Q000191:economics / Q000534:rehabilitation / Q000628:therapy*; D017410:Practice Guidelines as Topic; D017009:Professional Autonomy