BASIS OF DECISION-MAKING IN MEDICAL CARE AND

• Published in: Kekkaku(Tuberculosis) Vol. 58; no. 2; pp. 87 - 103
• Main Authors: GYOTEN, Yoshio, KINO, Chiekoh, TERAMATSU, Takashi, SATO, Akira, NAKAMURA, Kenichi, SHIMAMURA, Kikuji
• Format: Journal Article
• Language: English
• Published: JAPANESE SOCIETY FOR TUBERCULOSIS 1983
• ISSN: 0022-9776; 1884-2410
• DOI: 10.11400/kekkaku1923.58.87

We are now facing the following three major problems in general health care of Japan; a rapid aging of the population, a flood of informations and revolutional advances in technology, and an introduction of financial considerations to the cost of medical care. In accordance with the rapid decline of mortality and prolongation of the average span of life, the proportion of persons aged 65 and more to the total population has been increasing rapidly. It was less than 5% in 1930 and increased to 7% in 1970, and by the year 2000, it is estimated to exceed 14%. It took 80 to 200 years in developed countries that the proportion of persons aged 65 years and more raised from 7% to 14%, while in the case of Japan, it will occur in about 30 years. Such a rapid increase of the aged population has never been experienced in any country of the world, and it directs the future medical care from “cure” of patients to “care” of patients. A flood of informations brought out by computer and other revolutional advances in technology involved medical care, and there has been a woory that the good human relations between doctors and patients might be lost. Doctors have to notice now that the decision-making based on several informations is a responsibility of a doctor, and he should not be ruled by a computer. Based on a concept that a life of human being is heavier than the weight of earth, the increas ing cost for medical care has been covered mainly by various health insurance schemes and partly by public funds. However, slow-down of the development of Japanese economy has made it difficult to meet with the rapid increase of the cost for medical care, and financial considerations have been introduced into the cost of medical care. Future direction of tuberculosis programme must be discussed taking into account the above three major problems, and doctors have to make decision on the evaluation of real magnitude of tuberculosis problem and how much help we can give to the existing patients.