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[Breaking news] New Corona Announcement of 14 new infections in Nagasaki Prefecture

 
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On May 5, a woman over the age of 31 died in Nagasaki during hospitalization.
 

On June 6st in Nagasaki Prefecture, it was announced that 1 new people were infected with the new coronavirus.Infected person announced ... → Continue reading

 KTN TV Nagasaki

"TV Nagasaki" (Fuji TV affiliate) news account. We will send you the latest news about Nagasaki Prefecture.


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hospital

Hospital.png

hospital(Hospital,British: hospital) Is a facility (of which a certain size) provides medical care to people with illness or illness (sick people, patients) and accommodates sick people.[Note 1].

The founder of the hospitalPublic sectorHealth organizations (commercial or non-profit organizations),Insurance company, Charity, etc.Historically, many hospitals are religiousOrder,philanthropistHas been established and operated by[1].

Etymology

The word "hospital" is Latin hospesDerived from (guest), it is a word that means "detention facility for the sick and injured" (hotels Etymology is the same).So this word used to beNursing home, Yoroin,OrphanageIt was also used in the sense of.

The Chinese word "hospital" isLightEndJesuitsGiulio AlenioFirst appeared in "Zhifang Waiji" (1623).This book was imported during the Edo periodDutch scholarUsed by[2].Boshin WarThe word "hospital" used in those days was writtenflag Juntendo UniversityStored in[3].

History

Ancient greekAsclepiusIt is said that the temple was functioning as a kind of hospital[4]. Also,Faxian"Faxian's BiographyAccording to, around 400 ADIndiaThen, "Fukutoku Pharmaceutical House" was built to collect sick people, disabled people, orphans, poor people, etc., and treat them and feed them.[5].

IslamIn 707 in the world(I.e. OfDamascusIt was the first time that a hospital was built in[6].Haroon At RashidUnderBaghdadA hospital was built in.

Westernキ リ ス ト 教In the worldNun-MonkGathered the sick to serve God and took care of them in their daily lives.this isNurseIt is also the origin of the activity.ReformationSince then, hospitals have been separated from religion in Protestant lands. Since the 18th century, hospitals have moved away from poverty relief and have become specialized and used exclusively for the treatment of illnesses and injuries. 19th centuryFlorence NightingaleRevealed that nursing also requires vocational training.

The first hospital in Japan1557ToDoctorWas alsoPortugal OfMissionaryLuis de AlmeidaByNow OfOitaOita CityKentokumachiIt was in 2-chomeDeus HallIt is said that it is a hospital opened next tosurgical,Internal medicine,LeprosyIt had a department and was also equipped with Japan's first hospitalization facility.[7]. This isWestern medicineIs said to be the place where was first introduced[8].

Wartime international lawSo, attacks on the hospital are banned,War crimes.

Hospitals in each country

The United States of America

The best hospitals in the United StatesUS News & World ReportIn the magazineMayo ClinicWas selected (2014-2015)[10]..In a private companyHospital Corporation of America TheNew York Stock ExchangeIs listed on[11].

Thailand

ThailandThen,Bumrungrad HospitaletcListingIs the country's stock indexSET indexIt is adopted in the constituent stocks of.

Chugoku

Any subscriber can use it to pay the fee[12].

Malaysia

IHH Healthcare Malaysia Stock ExchangeandSingapore Stock ExchangeListed on the stock exchange, the company expands multilaterallyAsiaThe largest hospital owner[13].

Japan

Medical lawWhat is a "hospital" inMedical institutionOne of the functional categories of.in JapanMedical lawAbove, medical institutions of a certain size or larger are called hospitals, and small-scale ones cannot use the name of hospital as a clinic.However, regardless of the hospital or clinic, because of the meaning of the place where medical care is provided.HospitalIt may also be called.Hospitals must be organized and operated with the primary purpose of providing the injured and sick with the convenience of receiving scientific and proper medical care (Medical lawThe latter part of Article 1-5).

What is a "hospital"?DoctorOrDentistIs defined as a place of medical practice or dentistry for the public or a specific majority.Hospital bedHas an inpatient facility (ward) with more than 20 bedsPoint to things (Medical lawArticle 1-5 first sentence).No floor or 19 beds or lessClinic(If you have an inpatient facility, it will be a bedded clinic).

In recent years, due to the spread of medical care in Japan, the number of people who are ending their lives in hospitals is increasing.In most cases, the place where humans are born (childbirth) is also a hospital.Maternity hospital.

Opening regulations

Viewed by creatorJapan OfMedical institution(November 2019)[14]
hospitalGeneralClinicDentistryClinicmeter
Country3225374863
Public medical institution1,2023,5222614,985
Social insurance affiliates514507508
Medical Corporation5,72043,59314,76264,075
Individual17441,07353,13394,380
Others83113,44133314,605
meter8,300102,61668,500179,416

Hospitals are located in prefectures in JapanMedical planBased on the medical lawPrefectural governor OfAuthorizationNeeds.If the number of beds is excessive, it is possible not to give permission to open the bed, and demand is adjusted.

As a general rule, hospital managers (such as the president) must be doctors and dentists (Article 10 of the Medical Care Act. However, due to the sudden death of the manager, other than doctors may be permitted).

Many hospitals are based on the non-profit principles of the Medical Care ActLocal government,Independent administrative agency, Office unionJapanese Red Cross SocietyOther than public organizations such asMedical Corporation(Other eachUniversityFaculty of medicineAffiliated hospital (University hospital),Social welfare corporation,Religious corporation,CooperativeNon-profit organizations centered on (etc.)Public interest corporation) Is allowed to be established, and the company organization is exceptionally some companies for the purpose of welfare (mostly "" of major companiesHealth insurance association(Operated by) and hospitals established by JR, NTT, Japan Post, etc., which took over the hospitals under the jurisdiction of national special corporations (assuming that general outsiders other than those related to the founding company can also be examined. ) Exists.However, as an exception, there are hospitals that are operated as joint-stock companies due to historical background (such as being operated before the war) (Aso Iizuka Hospital,Osaka Kaisei HospitalSuch).This is an "exception" because it cannot be said that a joint-stock company has entered the operation of a medical institution.

In addition, although the notation "individual hospital" is sometimes seen, pure "individual hospital" is an unincorporated hospital that is "individual" in the following types (Sole proprietorship) Hospital.One-person doctor medical corporationIt is different to describe a standing hospital as a "personal hospital".

Building Standards LawBy the hospitalFirst-class low-rise residential area,Second-class low-rise residential area,Industrial area,Industrial area(On the other hand, clinics can be installed regardless of the area of ​​use).

Name

Facilities that can be called "hospitals" are limited to hospitals under the Medical Care Act.In addition, the name of the hospital is publicIndependent administrative agencyExcept for Ritsu (National Hospital Organization, etc.), the word "hospital" is generally included (administrative guidance).

Types

Type by founder

(According to the classification of the founders of the medical facility survey by the policy director of the Ministry of Health, Labor and Welfare)

Classification on the medical system

Hospital accounting

In Japan todayUniversal insuranceWe have adopted a system, and even if you receive a medical examination at a hospital, the total treatment cost will be covered.Self-payThe maximum rate is 3%.Therefore, it is often not a great financial burden for the user.However, it should be recognized that the price of medical services is actually high (more than three times the actual cost).

Especially normalchildbirthIs not covered by public medical insuranceLump-sum birth allowanceIf the hospital does not support reimbursement by the hospital, the full amount of the delivery cost must be paid in one lump sum at the time of discharge.Also, at the time of consultationInsurance cardIf you do not have the original (copy not allowed), the treatment fee at that time will be paid in full in principle like the uninsured person.In such a case, by submitting the receipt at that time to the insurer along with the prescribed application form, the amount will be refunded after deducting the original self-pay portion in principle.

Recently, it has become a social problem, such as unpaid even 3% of the medical expenses that should be borne.At this rate, the level of public medical services is in danger of collapsing.Under the Medical Care Act, you cannot refuse a medical examination unless you have a valid reason.You cannot refuse a medical examination because of unpaid payment"WhenNoticeBecause it has been raised[15], Both the insurer and the hospital must stay healthy or manage their money so that they are not blacklisted.

Credit / debit card payment

From around 2004Visa InternationalIn the CM, "Payment at the hospitalBy VISAHowever, in the present age when medical expenses are soaring, even if the amount of outpatient accounting is less than 1 yen per case, the payment of inpatient treatment costs is per case. Tens of thousands of yen-Because it is expensive, over one million yencashThe potential need to pay by credit card when you don't have itnicheIn various fieldsCredit card companyFrom the point that the member store fee income can be expected to be large2004From all over the countryNational Hospital Organization・ Most of the Red Cross Hospitals and Industrial Accident Hospitals have credit cards.debit cardIt corresponded to the payment by.(The service at the National Hospital Organization is by credit card payment.Public moneyBecome a storage modelFujisawaThen.taxCan now be stored by credit card payment)

In the case of national institutions, as a general rule, money can only be stored in cash, so payment by credit card etc. was not possible, but at national hospitalsIndependent administrative agency(National Hospital Organization), National UniversityNational University CorporationDue toAccounting methodSince the above restrictions have been lifted and the national (university) hospital has begun to handle credit cards, other public and private hospitals will follow suit.In particular, the increasing number of cases where ATMs of banks installed in hospitals are being removed is also accelerating credit card support.

In recent years, paying for treatmentTMJDo it with a machine likeAutomatic checkout machineThere are hospitals whereElectronic medical recordIt is linked with the system etc.), but when making a card payment there, the cardPINInput is required.

Benefits on the user (patient) side
  • You don't have to carry a lot of cash to pay for treatment, just in casetheftEven if you treat it, the damage will be reduced.
  • Depending on your own pocket, you can pay the treatment fee in one lump sum, or divide it.revolvingYou can also pay. (However, in principle, it cannot be used beyond the limit)
  • Credit cardPointHowever, you can earn as much as shopping with credit.
  • The place of use, amount of money, etc. are printed on the usage statement. (It can be used as a substitute for a household account book or for later recording.)
Benefits on the hospital side
  • Cash management will be reduced by reducing the amount of cash handled.
  • Reduction of receivables (creditors when paying with a credit card will be the user's card company).
  • If you have an automatic payment machine, you will have trouble with money (jamAccounting procedures can be completed in about 1 minute as the number of clogging is reduced, and congestion at the accounting counter can be reduced. (Many models accept only up to 50 banknotes.)
  • Only with a merchant contract with a specific credit card companydebit cardCan also be handled.
  • Available on credit card company websites and pamphlets Can be posted as a medical institution.
Demerit
  • Hospitalization /Complete medical checkup・ If the medical fee is expected to be high due to free medical treatment, the patient needs to check the amount of his / her card available in advance.(Debit cards are magnetic up to 50 to 200 million yen per dayCash cardIt is often included in the usage limit.In addition, if you inform the card issuer of the purpose of use of the credit card in advance and pass the examination, you can temporarily increase the usable amount. )
  • It is said that the member store fee (about 1% -5%) depends on the usage fee of the communication line and the payment transaction amount of the patient.Ministry of Internal Affairs and CommunicationsAccording to the results of a survey of national (university) hospitals in the jurisdiction by the Chubu District Administrative Evaluation Bureau, 0.6-1%[16], 3.24% for "Coiney," a credit card payment agency for medical institutions[17]) Will have to be borne by the medical institution (member store) side to Acwire (coordinating contract card company).
  • If a medical institution (member store) loses power (such as in the event of a disaster), card payment may not be available.
  • It is necessary to confirm in advance with a medical institution whether it is possible to pay with your credit card (international brand).

In addition, the treatment cost was originally high (Free medical careA human dock that is willing to pay a credit card usage fee of about 5% to 10% of the payment amount.Dentistry-Cosmetic surgeryEach specialty such asclinic・ In hospitals, we were able to handle it by contracting with a card company as a member store, but in any case, since 2004, it has begun to spread mainly in private hospitals and hospitals attached to university medical schools.The University of Tokyo HospitallifeThe affiliated card "" is called "Express Accounting", which allows you to go home without having to stop at the accounting counter or wait after the outpatient medical examination / examination is completed.Post payIt is reported that it provides services and is considering generalization to other hospitals.

Criticism

The business of the hospitalHealthThe main treatment is for people with the above problems.Continuous depending on the patient's acute / subacute / chronic conditions, etc.NurseOr need to be observedpatientInpatient treatment is performed.On the other hand, especially in the chronic phase and long-term care medical facilities, etc.dementia,paralysis,Mental illnessFor those who have difficulty living in the general societyMedical scienceThere are situations in which hospitals are forced to stay in hospitals for long periods of time, whether or not they are needed, and these are hospital misuses (Fehlbelegung) in Germany.[18],in JapanSocial hospitalizationKnown as[19].

In particular, Japanese hospitals have been pointed out as having an average length of hospital stay, and have maintained the number one position in the OECD for many years.[9]..This is Japan where it is difficult to accept non-healthy people into societywelfareIt reflects the system.Especially about 1/3 of inpatientsPsychiatricI am an inpatient in the ward, and this situationJapan Medical AssociationPresidentTaro Takemi"Psychiatric care is a livestock industry"[20].. The OECD has described the situation in Japan as "keeping patients hospitalized is an easy way to increase hospital income.[19]","Japanese mental healthThe policy is behind in "deinstitutionalization" compared to other countries, and stands out in a bad sense such as the large number of psychiatric beds.[21]"And so on.

Problems due to revision of medical fees

  • Due to the revision of medical fees in 2006, a 7: 1 nursing placement standard frame was established in addition to the conventional nursing placement standard.On top of that, medical fees have been significantly reduced in hospitals that do not meet the 7: 1 nursing placement criteria.As a result, the number of hospitals that cannot secure the target number of nurses, reduce the number of beds and meet the medical fee standard, and the number of hospitals that are forced into bankruptcy due to poor business conditions are increasing.
  • On the other hand,OsakaAt the hospital insideIncome hidingAnd overstated expenses, and then with the money that was raisedDoctor,nurseHas been found to have been pulled out from another hospital[22], Morals over hospital managementcomplianceConsciousness is regarded as a problem.

Hospital architecture

Since medical practice is a traditional practice that has been practiced for a long time, hospitals have a long history.world HeritageSome have become.メキシコ OfHospicio Cabañas,スペイン OfSant Pau Hospital,トルコ OfGreat mosque and hospital in DivryiIs a good example.

Until modern times, hospitals were more than a place of treatment.InfectionPatient orMental illnessIsolate the patient or feed the poorbedThe role of providing was greater.for that reasonPoorThe ward for people is always over capacity, and it is said that several people share one bed, which is still the case in developing countries.

On the other hand, the wealthy people are treated at home,Doctor OfHome visitReceiveMaidWas receiving long-term care by.Aiming for an environment close to this, we proposed a hospital for healing.Florence NightingaleIs.Advocated by herNightingale wardIs limited to about XNUMX patients as one nursing unitnurseIt is designed to provide as much nursing care and treatment as possible even in situations where there is only one.

20st centuryWhen you enter, the hospitalModernism architectureAffected by. In the first half of the 20th centuryDedicated to pre-school and extra curricular,Jail-刑 務 所It was made with the same design concept as the facility[23].. IeDaylightIn order to improve the condition, there are many long and narrow floors with a central corridor type, which is in line with the hospital room.nurse stationExisted.

In the second half of the 20th century,The United States of AmericaA design concept specializing in hospitals is born around.Placed in the center of the floor to reduce the distance from the nurse station to each hospital room, and the shape of the floorRound,triangle, The flow line was devised as a polygon.The reason why all rooms are private rooms or less than double rooms is partly because of the shortening of the flow line.[24].

It was in the 1990s that such design ideas began to be adopted in Japan, but nowadaysUniversity hospital,Prefectural hospitalThis design concept is mostly incorporated in the renovations such as.

footnote

[How to use footnotes]
Note etc.
  1. ^ Medical facilities smaller than hospitalsClinicIt is called (clinic).Although it is a hospital on a scale, some facilities retain the name of the clinic for historical reasons (Mayo ClinicSuch).
Source etc.
  1. ^ Hall, Daniel (December 2008). “Altar and Table: A phenomenology of the surgeon-priest”. Yale Journal of Biology and Medicine 81 (4): 193–8. PMC: 2605310. PMID 19099050. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2605310/ 2013/7/9Browse"Although physicians were available in varying capacities in ancient Rome and Athens, the institution of a hospital dedicated to the care of the sick was a distinctly Christian innovation rooted in the monastic virtue and practise of hospitality. Arranged around the monastery were concentric rings of The outer ring of buildings served as a hostel in which travelers were received and boarded. The inner ring served as a place where the monastic community could care for the sick, the poor And the infirm. Monks were frequently familiar with the medicine available at that time, growing medicinal plants on the monastery grounds and applying remedies as indicated. 
  2. ^ Kiyohide Arakawa"Formation and Propagation of Modern Japanese-Chinese Academic Terms-Focusing on Geographical Terms"Hakuteisha, 1997, pp. 29-30.ISBN 4891743220.
  3. ^ "Medical exhibition" It must have hurt "Empress Juntendo". Asahi Broadcasting(July 2014, 4). http://webnews.asahi.co.jp/ann_s_000024828.html 2014/4/15Browse. 
  4. ^ Risse (1999) p.56ff
  5. ^ Faxian"Faxian's Biography"The chief of the country and the resident of the castle, Fukutoku Pharmaceutical House. Poverty, loneliness, remnants, all sick people, all the sick people, all the seeds supplied. Self-reliance. "
  6. ^ Risse (1999) p.125
  7. ^ "JesuitsShi Nihon Tsushin (NewExotic book 1)』125~126頁、150~151頁、177~179頁、188~189頁、191~192頁  (Showa43 years(1968)May 12Publisher:Naojiro Murakami Editor: Takeo Yanagiya Publisher:Yushodo Publishing)
  8. ^ "NanbanMedical Almeida, pp. 45-68, "4 FuchuProof of hospital location "(1993May 9Publisher:Toshio Tono Publisher:Kashiwa Shobo)
  9. ^ a b c Health at a Glance 2013 (Report). OECD. (2013-11-21). two:10.1787 / health_glance-2013-en. 
  10. ^ “Best Hospitals 2014-15: Overview and Honor Roll”. US News & World Report(July 2014, 7). http://health.usnews.com/health-news/best-hospitals/articles/2014/07/15/best-hospitals-2014-15-overview-and-honor-roll 
  11. ^ "US Hospital Listed on NY Market Japan Introduces Management Co., Ltd."(July 2011, 3). http://the-liberty.com/article.php?item_id=1521 2014/8/30Browse. 
  12. ^ Yutaka Kitamura "The eerie and distorted medical insurance system where" prescription drugs, buy high "is rampant" makes citizens run for pocket money "Nikkei Business Online" delivered on June 2009, 6 "Co., Ltd.Nikkei BP"
  13. ^ “Raised 1500 billion yen for listing in Asia's largest hospital group”. Nikkei(July 2012, 7). http://www.nikkei.com/article/DGXNASGM1302D_R20C12A7NNE000/ 
  14. ^ 2019 Medical Facility (Dynamics) Survey / Hospital Report Overview (Report). Ministry of Health, Labor and Welfare. (2019). https://www.mhlw.go.jp/toukei/saikin/hw/iryosd/19/. 
  15. ^ September 24, 9 Notification of No. 10, Director General of Medical Affairs Bureau, Ministry of Health and Welfare "Matters related to medical treatment at hospital clinics"
  16. ^ I want more hospitals that accept credit cards to pay for medical expenses (overview)Ministry of Internal Affairs and Communications Chubu District Administrative Evaluation Bureau
  17. ^ Introduction page of Coiney, Inc.
  18. ^ "Germany's Social Hospitalization / Cooperation Issues and Related Legislation (Special Feature: Elimination of Social Hospitalization)"Health Insurance Federation Overseas Medical Insurance" Vol. 87,Federation of health insurance associations, November 2010, pp. 9-10, NOT 40017351301.
  19. ^ a b OECD Economic Surveys: Japan 2009 (Report). OECD. (2009-08-13). Pp. 112-113. two:10.1787 / eco_surveys-jpn-2009-en. ISBN 9789264054561. 
  20. ^ "Bomb Psychiatrist" Information Center Publishing Bureau, Nov. 2008, 11, p. 5.ISBN 978-4795849426 . 
  21. ^ Making Mental Health Count --The Social and Economic Costs of Neglecting Mental Health Care (Report). OECD. (2014-07). Pp. 15-16. two:10.1787 / 9789264208445-en. 
  22. ^ Osaka hospital pulls out doctors and nurses with hidden income ... National tax pointed out Yomiuri Shimbun May 2008, 12
  23. ^ Michelle Foucault"Birth of a prison』Shinchosha
  24. ^ Edited by Luis G. Redstone Translated by Kazuo Tanaka "Hospitals and Medical Facilities" Keigaku Shuppan Contemporary Architecture Collection

References

  • Guenter B. Risse (1999). Mending Bodies, Saving Souls: A History of Hospitals. Oxford University Press. ISBN 0199748691 

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