臨牀透析 Vol.17 No.13(2-2)


特集名 介護保険と透析医療
題名 各論:いわゆる複合施設と透析患者の介護保険
発刊年月 2001年 12月
著者 川村 直人 川村第一病院内科
【 要旨 】 近年,要介護透析患者の増加は著しく,社会的入院も増加している.病院,老人保健施設(老健),特別養護老人ホーム(特養)などを一体とした複合施設は,その受入れ先として期待されている.透析施設と介護施設の併設により,透析への送迎にかかる労力と費用の軽減を期待できる.また,施設間の協力により食事管理,看護不足などの問題も改善が期待できる.しかしながら,介護施設へ入所した場合の,患者の自己負担金増加と透析における診療報酬の減額については,改善されるわけではない.要介護透析患者の複合施設内の入所先としては,入院ベッド不足の事情より,本来ならば特養や老健が望ましい.しかし現状では,療養型病床への入所が多くなると考えられる.
Theme Curent Status and Problem of Long Term Care Insurance System for Dialyzed Patients
Title Planned complex and long term care insurance for dialysis patients
Author Naoto Kawamura Department of Internal Medicine, Kawamura Daiichi Hospital
[ Summary ] In recent years, the number of dialysis patients in need of nursing care has markedly increased and the number of elderly needing hospitalization for non-medical reasons has also increased. This complex includes a hospital, health care facility for the elderly, and a special nursing home for the elderly, in anticipation of the need to provide care for this population. In such centers, the combination of a dialysis facility and a nursing and personal care facility may save the expense and labor which drive patients to dialysis centers. Inter-facility cooperation can facilitate dietary control and help to alleviate the nursing shortage. With admission to such centers, however, patient's individual payments will increase and medical fees for dialysis will decrease. Placing admitted dialytic patients, needing nursing care, in a special nursing home for the elderly or health care facility for the elderly is preferable because of the shortage of hospital beds. Given current conditions, however many of these patients may be placed in convalescent wards in hospitals.
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