[Home care in Sapporo].

We established a clinic specialized in home care in Sapporo in July 2001. In these 2 years we have provided medical home care service to 160 patients, and 97 are still receiving regular service. At first we accepted any patients living within 16 km from the clinic. However, bad traffic conditions in winter made it difficult to visit patients living in districts far away from the clinic. Therefore, we planned a network of home care physicians in Sapporo. Now 12 home care physicians hold monthly meetings. In Sapporo, meetings of home care related workers are organized in each ward, as suggested by the Sapporo Medical Association. There is a relatively good supply of home care related services and resources, including availability of an important number of visiting nurses. Patients being taken care of at home who present an acute exacerbation of symptoms are relatively easily accepted by acute hospitals. But those who have difficulties in continuing home care due to a sudden change in family conditions are not easily accepted by nursing hospitals. Recently, the number of group homes and lodging houses for elderly persons has markedly increased in Sapporo. It might have some problems in medical support in the near future.