When the super-old society encounters medical collapse, the story of self-help in Xizhang City, Japan

What will happen if medical care collapses again in the ultra-old society? There is a classic case in Japan, which is located in Xizhang City, Hokkaido.

The National Development Association predicts that Taiwan Province Province will enter the super-old society in 2025, Taiwan Province Province will catch up with Japan in 2050, and even the elderly population rate will exceed 40% in 2060.

In 200 1 year, the elderly population in Xizhang reached 3 1.6%, 44.7% in 20 12, and 47% in 20 15 this year. It is no exaggeration to say that Xizhang City reflects the Japanese society after 2050. But this place is not only super old, but also a real medical collapse. After the closure of Xizhang Municipal Hospital, there was a miracle? What's going on here?

Xizhang City is an immigrant city that has made a fortune by mining. Because of the developed mining industry, people's livelihood and social welfare are subsidized by enterprises. Before bankruptcy, health care and running water were free. The good times didn't last long. After the mine was closed and the enterprise withdrew, the working population dropped sharply, and young people flowed out. Taxes were not enough to pay for public facilities and civil servants, which eventually led to the bankruptcy of the local government. The city * * * was unable to run the Xizhang Hospital, so in 2007, Dr. Tomoko Murakami, the hope of Xizhang, took over and transformed the original 17 1 bed general hospital into a 19 bed Xizhang clinic and a 40-bed medical and health care institution for the elderly. In other words, hospital beds have been reduced by nearly 90%.

According to the research published by Dr. Yoshida Morita, director of Eve Zhang Clinic in 20 14, the death toll in Xizhang City has not increased significantly in the past 12 years. As a result, the attendance rate of ambulances has been reduced by half, and the attendance rate of receiving medical treatment and care at home for 24 hours has increased a lot. Other emergencies that need hospital treatment, such as fractures, are transferred to a large hospital by helicopter and then returned to their own homes to recuperate. Therefore, the proportion of death caused by aging at home has greatly increased. It can mean to die well.

Unexpectedly. Although the cost of long-term photos is higher than that of other places in Hokkaido, the medical expenses are much lower, and each elderly person saves 6,543,800 yen in medical expenses every year than expected. Therefore, the overall health care expenditure is lower than other places in Hokkaido. It can also be said that home medical care has reduced a lot of ineffective medical care.

The economist Dr. Morita not only published quantitative research, but also added his own observation notes. Through the fictional Morita classroom, he published a book, Miracle of Collapse: Lessons from Xizhang Citizens, which was read by the public in the form of a dialogue between teachers and students.

Many people mistakenly think that Zhang Xi's medical expenses are reduced because? The hospital is closed? However, although the total population of Xizhang City has decreased, the population over 65 has not decreased significantly, and the population over 75 has been increasing. If it is not the change of the concept of the elders, choose? Do your best and know your destiny? Insist on dying at home, even if the hospital closes down, the elders will still be transferred to the city where their children live and receive life-sustaining medical care until the last moment.

Morita further analyzed that the number of critically ill patients has not decreased, for example, the number of elderly people receiving renal dialysis has not changed. Therefore, Morita believes that the change of death concept is the core factor.

Although hospice care in Taiwan Province Province ranks sixth in the world, cancer is still the main target. In the super-old society, it is still an arduous project to let the elders die at home. Facing the increasingly severe medical environment, the rapid growth of aging+fewer children, it is suggested that the experience of Xizhang City should be incorporated into the aging policy for more reference.

Ted.

Amazonas

& lt This column reflects experts' opinions and does not represent our position >