Trends associated with Home Care Supporting Clinics (HCSCs) in Japan.
OBJECTIVE
HCSCs were introduced in Japan in April 2006 with the aim of playing a central role in providing end-of-life care at home. However, it is unclear how the HCSCs are operated because statistical data regarding their activities have not been disclosed to the Japanese public. The purpose of this study was to describe the trends associated with the HCSC activity in Tokyo, Japan.


METHODS
We submitted an application to the relevant government ministry to disclose the annual activity reports from 2008 to 2010 of the HCSCs located in Tokyo. Reports from each HCSC contained information on the number of patients, the number of deceased patients, their place of death and the number of home visits by physicians and nurses.


RESULTS
The number of HCSC activity reports for each year was 1166 (2008), 1209 (2009) and 1246 (2010), while the total number of patients for each year was 67,765 (2008), 67,094 (2009) and 83,486 (2010). Patients who died at home each year under the care of HCSCs was 4431 (2008), 4786 (2009) and 5234 (2010). It is of note that in 2010 about 87% of patients were cared by HCSCs that cared for >50 patients a year and as many as 26.9% of patients who died at home utilized clinics that cared for >50 deceased patients a year.


CONCLUSIONS
The advent of HCSCs caring yearly for >50 patients and deceased patients has led to a shift in the location in which patients receive end-of-life care.
Division of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka 565-0871, Japan.
Akiko
A
Akiyama
Hiroo
H
Hanabusa
Hiroshi
H
Mikami
D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends; D006699:Home Care Services / Q000639:trends*; D006801:Humans; D013727:Terminal Care / Q000639:trends; D014041:Tokyo