日本家庭医疗中居家护理的角色

Role of visiting nursing care in Japanese home healthcare

2016年日本老龄化率已经达到27. 3%,预计2025年,日本战后婴儿潮时代迈入75岁大关,将衍生出长期照顾及临终安排的问题。自1976年以来,日本人居家死亡逐渐被在医院死亡取代,经过这几年家庭医疗的发展,2016年,在家死亡的比率已升至12. 7%。但是,日本将在2040年迎接人口死亡高峰,届时每年将有167万人死亡。因此,2012年日本政府强力推动"社区整体照顾系统",居家护理在家庭医疗中责任重大。2016年日本有8 613家居家护理机构,护理57万在家疗养的患者。作者通过综述日本过去居家护理的发展状况,旨在为我国居家护理的发展提供借鉴作用。

In Japan, the aging rate has reached 27.3% in 2016. By 2025, when the baby-boomers become 75 years old in Japan, issues of long-term care and end-of-life care will be more important and challenging. Since 1976, more Japanese have died in hospital settings than in home settings. Although the percentage of people dying at home increased slightly to 12.7% in 2016, after the recent introduction and promotion of home healthcare, Japan will face a significant challenge to deal with high natural death rates, which is expected to impose a heavy death burdened on society by 2040, when the death rate is expected to reach 1 670 000 per year. Therefore, the Japanese government have begun to promote the Community-based Integrated Care System, in which home healthcare and visiting nursing play crucial roles. This article summarizes the historical trend and current situation of visiting nursing in Japan. The total of 8 613 visiting nursing stations that were active in community settings in 2016 and cared for 570 000 patients in home settings. The development of home healthcare in Japan will be reviewed in order to provide references for the development of home healthcare in China.