title: [Actual applications of the Medical Treatment and Supervision Act: a survey of hospitals and the Ministry of Health, Labour and Welfare].
abstract: In November 2010, a report on implementation of the Medical Treatment and Supervision Act was submitted to the Diet, as provided for in the law. However, the report did not sufficiently describe conditions surrounding actual applications of the law, and subsequently the legal affairs committee of the Japanese Society of Neurology and Psychiatry carried out a survey regarding several items not covered in the report. Survey targets were 28 hospitals treating inpatients under the Medical Treatment and Supervision Act (Part 1), and the Ministry of Health, Labour and Welfare (Part 2). Part 1 comprised three items: 1) rulings to dismiss petitions for discharge; 2) rulings to dismiss petitions for continued hospitalization; and 3) rehospitalization under the Medical Treatment and Supervision Act. Survey results showed that, of 16 rulings against petitions for discharge, only two were considered reasonable by the hospitalizing institution. This offers an excellent opportunity to examine the remaining cases in detail and highlight problems related to the law, such as the issue of social hospitalization and questions regarding differences in diagnosis and risk assessment. Of 17 cases of rehospitalization under the Medical Treatment and Supervision Act, eight cases were deemed to involve some mistakes or deficiencies in treatment during the initial hospitalization. It is important to examine details of treatment during initial hospitalization, and treatment and support provided after initial discharge, in these cases, as well. The survey sent to the Ministry of Health, Labour and Welfare consisted of 17 items, but responses were received for only three items: 1) checks and collections of reports; 2) the detailed contents of requests in 79 cases where improvements in treatment were requested; and 3) the details of 19 cases where patients were transferred to other medical facilities for hospitals covered by this law. However, the present survey by itself does not reveal the full details of even the three items for which responses were received, highlighting the importance of increased disclosure of actual applications of this law in the future.
mesh_terms: D003625:Data Collection; D035082:Federal Government; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006761:Hospitals / Q000639:trends; D006801:Humans; D007564:Japan; D010351:Patient Discharge / Q000706:statistics & numerical data / Q000639:trends*; D012946:Social Welfare / Q000706:statistics & numerical data / Q000639:trends; D000078329:Workforce