[Connecting between hospital, clinical and pharmacy--present and future]

Along with the promotion of "home medical care", an increasing number of clinics provide home medical care as part of their services or are dedicated to home medical care partly as a result of the reform of the healthcare system. This is considered to be the manifestation of the desire of patients to live their own lives and the intention of the healthcare professionals to satisfy patient needs. We examine what insurance pharmacies should and must do to provide higher-quality services to satisfy such patient needs, this time focusing on the community coordination for the purpose of providing the services which can give sense of security to patients.

Cases of HPN during the period from July 2002 to June 2003 were subdivided into those in which we were involved before and after the discharge from the hospital and those in which we were involved only after the discharge from the hospital to home medical care and comparatively studied from various perspectives. Existing coordination systems are introduced and discussed to achieve the desirable coordination systems.

In the home guidance service, some patients consult with us on the issues on which they hesitate to consult with doctors or nurses. This suggests that we can contribute to the mental care for patients and their care givers. In order to make the best use of our position, the coordination with hospitals is essential for insurance pharmacies. The degree of contribution to the improvement of QOL or the mitigation of anxiety over inexperienced issues is considered to differ depending on the preparatory period between the cases in which we were involved before and after the discharge from the hospital and those in which we were involved only after the discharge from the hospital to home medical care. The analysis of the differences in the actual cases is considered to be significant to seek for the ideal coordination.