With the spread of the new coronavirus infection, the tightness of beds is becoming more severe in various places, and how to secure beds is an issue.
In the area centered on Matsumoto City in Nagano Prefecture, we are trying to divide the roles of the hospitals in charge according to the severity of the patients in the "secondary medical area", which is the living area of the residents.
Nine hospitals in the "Matsumoto Medical Area", which has 3 cities and 5 villages, including Matsumoto City in Nagano Prefecture, Shiojiri City and Azumino City, assume the required number of beds according to the number of patients in the new Corona. The number of patients and roles to be accepted are assigned to each hospital according to the patient's condition such as the severity of symptoms and whether artificial dialysis is necessary.
According to Takao Aizawa, chairman of the Japan Hospital Association and one of the private hospitals in the Matsumoto medical area, Aizawa Hospital, the top of the hospitals in Matsumoto City and the region last April when the infection of the new corona began to spread in Nagano Prefecture. After discussions, we decided on such a response.
Currently, the spread of infection continues in this area, with 84 cases confirmed in the week leading up to the 21st, but in public and public hospitals through discussions between hospitals ▽ Shinshu University Hospital Is a patient with severe and moderate illness, ▽ National Hospital Organization Matsumoto Medical Center and ▽ Matsumoto Municipal Hospital, Azumino Red Cross Hospital mainly accepts patients with moderate and mild illness, and ▽ Prefectural Children's Hospital accepts children and pregnant women.
In addition, private hospitals also accept ▼ Aizawa Hospital and mainly moderately ill patients, and ▼ Matsumoto Kyoritsu Hospital mainly accepts mildly ill patients.
On the other hand, ▼ Fujimori Hospital and ▼ Marunouchi Hospital are in charge of treatment other than corona patients.
Chairman Aizawa should plan the division of beds and roles based on the estimated number of patients in direct consultation with the top management of hospitals and governments in the "secondary medical area" before the infection spreads rapidly. I am complaining.
Chairman Aizawa said, "It is difficult to secure a bed even if the government requests individual hospitals after the medical system is tight. In the Matsumoto medical area, hospitals communicated diligently from normal times, and the leadership of the government. At first, I was asked to secure many corona beds at the city hospital, so the division is working well. "
On the other hand, in areas where the infection situation is severe, such as Tokyo, it is difficult to establish a system, said Chairman Aizawa, "Before the third wave of infection comes, the government will take the lead in creating a solid system. It should have been done. However, it is still in time in areas where the infection has not spread so much. Now in an emergency, we should proceed with the construction of a system that assumes the worst situation in each medical area. " did.
What is "secondary medical area"?
The "secondary medical area" is an area that is set to provide general inpatient treatment excluding advanced medical care, and is set across multiple municipalities, generally assuming the living area of residents. It has been.
It is determined in consideration of the population and the time required to access medical institutions, and there are 335 in total nationwide.
Each prefecture is based on the "secondary medical area" ▼ 5 types of illnesses such as cancer, stroke, acute myocardial infarction, diabetes, and mental illness, and ▼ emergency, disaster, perinatal, pediatric medical care, depopulated areas For the five medical businesses, we will create a "medical plan" that summarizes the system, considering which medical institution will be responsible and how many beds are required.
Expert "Securing beds by" centralized response "in areas where infection is rapidly expanding"
How to secure a bed in an area where the infection has spread rapidly and the infection situation is already severe, experts can also set up a hospital specializing in patients with the new coronavirus and centralize the response It is said that.
Professor Toshiki Mano of Chuo University, who is familiar with the medical care provision system, said, "Overseas hospitals such as the United States have a background of responding to wars and infectious diseases in the form of'field hospitals', and even the new corona has 500 beds. We have taken drastic measures, such as dedicating half to corona. As a result, the number of infected people is an order of magnitude higher than in Japan, but we have managed to accept patients. "
In Japan as well, in order to increase the number of beds, Tokyo Metropolitan Hiroo Hospital and other three hospitals have indicated that they will focus on accepting patients with the new corona and make them practically specialized hospitals.
Regarding these movements, Professor Mano said, "In Japan, there are only a few beds that support intensive care even in university hospitals, and it is difficult to increase the number of beds at once even if they become specialized hospitals." I think it is the right direction to set up a new corona hospital to respond to the rapid spread of infection. "
(Tokyo) Agreement with a private hospital to secure a bed
In Tokyo, Kanagawa, and Saitama, where emergency declarations have been issued, new initiatives have begun as the sickbeds become tighter.
In Suginami-ku, Tokyo, four core hospitals in the ward are currently accepting patients with the new coronavirus, but the bed usage rate continues to exceed 90%, and even though hospitalization is required, we have to recuperate at home. The challenge is that the number of new infected people who cannot get it is increasing.
On the other hand, there are some inpatients who cannot vacate their beds because they cannot find a transfer destination to continue rehabilitation even if their symptoms recover.
In response to this situation, Suginami Ward has a new agreement with 10 private hospitals in the ward to secure transfer destinations in order to facilitate the transfer of patients who have recovered from their symptoms and to accept new infected patients. We have solidified the policy of connecting.
The agreement includes that if inpatients at a hospital in the ward recover to meet the national discharge standards, the ward will adjust the transfer destination and the hospital with which the agreement has signed an effort to secure a bed.
The hospital that accepts the transfer will be subsidized by the ward ▼ 8,000 yen per bed per day, and ▼ 28,000 yen per day for private rooms for up to 10 consecutive days.
The agreement is set to be signed later this week, and the ward says, "We want to hurry up measures to secure beds to accept new infected people."
(Kanagawa) Specialized team for securing beds started activities
According to the summary of Kanagawa Prefecture, there are more than 1000 beds that can be used immediately in the prefecture, but the usage rate as of the 20th was 88%, and since the 10th of this month, it has been around 90%.
For this reason, the prefecture created a new dedicated team this month to secure beds.
The team is asking hospitals in the prefecture for cooperation through video conferencing, but many hospitals find it difficult to increase the number of beds, and the team listens to what kind of support each hospital needs and resolves it individually. I actually started to go around the hospital because I needed to do it.
Today, a member of the team visited "Yokosuka City Hospital".
This hospital accepts about 30 patients with mild or moderate illness.
The hospital director explained that although there is still room for the bed itself, it is difficult to increase acceptance due to the lack of doctors and nurses because treating patients with the new corona is more labor-intensive than usual.
He asked the team staff to help transfer patients who were still hospitalized for medical treatment to another hospital after treatment.
Toshiharu Kitamura, director of Yokosuka City Hospital, said, "I want to cure more patients, but it is difficult to increase the number of beds in the current state due to the usual medical care and emergency response."
The team will continue to request all hospitals in the prefecture to secure beds.
Takashi Adachihara, the director of the medical institution coordination department, who oversees the team, said, "I would like to ask what is the problem to increase the number of beds, such as people, things, and systems, and solve each one." ..
(Saitama) Hospitals support the recuperators of accommodation facilities
In Saitama Prefecture, about 290 patients with the new coronavirus are being treated at accommodation facilities, and doctors and nurses are observing their health, but the issue is how to respond to changes in the medical condition as the person in charge changes daily. I am.
Saitama Prefecture, in collaboration with Kodaira Hospital in Toda City, which accepts patients with the new corona, started a new initiative last month to continuously observe patients being treated at accommodation facilities at the same hospital and to grasp their health condition in detail. I did.
If there is a need for a medical examination based on a report from a nurse residing at an accommodation facility in the neighboring Kawaguchi City, we will provide medical treatment online after confirming the person's intention.
In addition, if medicines such as antipyretics and diarrhea are prescribed, they can be delivered to the accommodation facility, and if treatment is required, they can be contacted with the prefecture and moved in a dedicated vehicle of the hospital for medical examination or hospitalization. I can do it.
According to the hospital, one or two people are now receiving medical treatment online every day, and in some cases they were hospitalized.
Kodaira Hospital's director, Kodaira Hospital, said, "I think that doctors at the same hospital will always be able to notice changes in symptoms and show signs of deterioration. It is possible to reduce even one patient who becomes severely ill. It's important. "