Hiroshima General Hospital and Its Involvement in Community Health Care-Especially with Respect to Prevention and Control of Cardiovascular Disorders / 日本農村医学会雑誌

ABSTRACT

Hiroshima General Hospital dates back to 1947. Initially it was known as the Saiki Hospital affiliated with the Agricultural Association of Hiroshima Prefecture. It had 60 sickbeds and four departments-internal medicine, surgery, otolaryngology and dentistry. In those days, there were a large number of atomic bomb survivors in this medically underserved province of Saiki, so that the hospital was extremely busy treating these hibakushas. With the increase in the number of patients, the hospital kept expanding. It was not until 1979 when the number of beds increased to 270 that the hospital was reorganized and assumed the present name. Since then, it has continued to expand and its medical facilities improved. Having been accredited with the type B general hospital by Japan Council for Quality Health Care, it has now become the nucleus of the health care system in the western part of Hiroshima Prefecture, with 570 beds.By way of illustrating how our hospital has been involved in community health care, we will take a look at the trend of the number of emergency cases admitted at night or on holidays. Up until 1998, the annual number of such cases had stood at somewhere around 4,000 but in 2003 the figure exceeded 10,000. For routine physical checkups, electrocardiograms are used. In 1975, 1,800 patients underwent ECG tests and in 2000 the number leapt to 27,000. This author has taken it upon himself to interpret all these ECG records.The Department of Cardiology in our hospital had made it a rule to conduct noninvasive testing in diagnosis. In 1984, the x-ray examination system to make a diagnosis of circulatory troubles was introduced. In 1988 when the Department of Cardiovascular Surgery was set up, it started employing percutancous transluminal coronary angioplasty (PTCA) procedures and other interventional techniques. At first, coronary artery imaging was preformed on not more than 40 cases annually, but now the number of such cases surpasses 500. Interventional treatment is given to well over 130 cases, 85% of which have stents implanted. The initial success rate of intervention is 90.3% and the rate of restenosis was 35.8%. The cases of A-C bypass grafting performed at the department of cardiovascular surgery are increasing in number. Now the use of skeletonized artery bypass graft surgery with extracorporeal circulation at normal temperature has become standard procedure. By the use of the multi-detector row helical CT (MDCT), we are now studying coronary bypass patency and imaging quality. Except for some cases, it has become possible to obtain three-dimensional reconstruction images comparable to angiocardiographic images in terms of quality. We expect that MDCT will replace catheterization and become a standard noninvasive diagnostic procedure in the foreseeable future.We will adopt new thechniques and new therapeutic methods positively but not blindly placing too much confidence in state-of-the-art technology. Based on the fundamental principles of our hospital, we will devote ourselves to medical care, putting the needs of patients before everything else.