[Home respiratory care in remote areas and on small islands in Japan: status quo and problems]

To investigate the status quo and problems regarding home respiratory care provided by medical institutes that played a central role in mountain villages and on small islands, we distributed a questionnaire in 250 remote medical institutes. The number of respondents was 116 (46.9%). Home oxygen therapy (HOT) and home mechanical ventilation (HMV) were carried out in 83 (71.6%) and seven (6%) institutes, respectively. The results of the survey regarding HOT in the remote medical institutes revealed that: (1) a large proportion of the patients were aged; (2) there were few cases per institute; (3) a high percentage of cases with chronic obstructive pulmonary disease (COPD) as the cause were evident; (4) visiting care was being provided in a high percentage of cases; and (5) few institutes were equipped with a spirometer. Overall examination of the responses showed that HOT was prevalent even in the remote medical institutes, and could be smoothly conducted, if communication with a medical institute specializing in respiratory diseases and an emergency transfer system could be established. On the other hand, the prevalence of HMV is still low, and problems such as the establishment of a medical team system and a caregiver support system has yet to be solved.