ABSTRACT
Objectives: The purpose of this study was to examine the occurrence of accrued receivables by types of medical insurance to clarify those responsible for the accrued receivables related to medical expenses.Methods: Using accrued receivable data for FY2016 (for practices from April 2016 to March 2017) obtained from Matsue Seikyo General Hospital, quantitative analysis was carried out for the occurrence of accrued receivables by hospital visiting patterns and insurance types.Results: The incidence rate of accrued receivables among all consultations at the hospital was 1.06%. The incidence rate was the lowest for patients with Union Health Insurance. On the other hand, the incidence rate of accrued receivables among patients with health insurance administered by the Japan Health Insurance Association, which is another employment-based health insurance, was three-times higher than that of those with Union Health Insurance, and higher than those with National Health Insurance or Advanced Elderly Medical Service. The incidence rate of public assistance was the highest at Seikyo General Hospital, including hospital admission; it was characterized by a high incidence of accrued receivables for expenses for diapers and hospital gowns during hospitalization.Conclusion: To mitigate this issue, cooperation of hospital staff was suggested to be important.
ABSTRACT
<p><b>Introduction: </b>To determine the requirement (s) that enables the elderly living on an isolated island to continue living on their familiar island. </p><p><b>Methods: </b>The annual reports on the internal migration in Japan derived from the basic resident registers of the Ministry of Internal Affairs were organized. A questionnaire survey and interviews were conducted with members of the resident welfare division of the village office of Chibu Village, Oki-gun, Shimane Prefecture, and the answers were qualitatively analyzed.</p><p><b>Results: </b>A large number of persons of advanced age have moved out from Oki Island. The destinations have varied by year and included places outside Shimane Prefecture. There were no hospitalization facilities or nursing homes in Chibu Village. The only establishment that provided nursing services was the social welfare council. Available home care services were only home-visit care and visiting care. The most common place of death was hospitals outside the island. The communities were characterized by strong ties and mutual assistance among people in the neighborhood, which supported the lives of aged members.</p><p><b>Conclusions: </b>For persons of advanced age living on an isolated island to continue living in their familiar area, it was found necessary to improve the system for receiving people of advanced age who require nursing, and enhance the link between the government and residents to maintain mutual assistance activities among residents.</p>