[Examination of local alliances in clinical path (home parenteral nutrition)]

In revising compensation for medical treatment, shifts in home care systems such as management of lifestyle-related diseases, management of a patient within reach of a daily medical treatment, and an attempt to curtail hospitalization are suggested as concrete means of planning medical expenses to be appropriate. In doing this, it is getting more important that the medical institution pursue its purpose and must select the course of treatment and to solidify a medical cooperation among the institutions because a medical treatment is often not concluded at only one medical institution. Although a revision of compensation for medical treatment is getting more difficult due to three consecutive negative revisions in the past, a new clinical path for a local solidarity of femoral neck fracture has been found. Because of this revision, we think that it is necessary to make a system able to shift medical treatment and to care from hospital to facilities in the district and at home. We studied the clinical path in order to develop an effective and solidified cooperation with people of the district with regard to home parenteral nutrition, which is the most frequent medical treatment in case of a home care shift from that of our hospital's support for patients leaving the hospital.