With the advent of a society in which the number of elderly people is increasing and the number of babies a woman gives birth to in her lifetime is decreasing, how to address to the future financial broblem of the nation's health insurance schemes has come up for discussion. Against the backdrop of quantitative repletion of medical care, the government has come pu with a policy calling for the containment of medical costs. Under the circumstances, it is expected that the proceeds from medical treatment will level off in years to come. To cope with the situation, the Federation of Agricultural Cooperatives for Welfare in Aichi Prefecture has planned to install a department-wise cost control system in its member hospitals with eht aim of making all staff members cost-conscious, profit-minded and futrure-oriented in every department. In this paper, the authors will present the system in outline and show the target number of patients set on the basis of the break-even point, financial analyses of departments where revenues are below the break-even point and measures to deal with deficits case by case. In addition, as a task to be tackled with, the need for the omprovement of the accuracy and the standardization of the system will be discussed.

Nusa Tengara Barat (NTB) province consists of two main islands, Lombok and Sumbawa, to the east of Bali Island, Indonesia. Most of the area is known to be moderately malaria endemic, but the exact malaria epidemiology has not been elucidated. At least 30 deaths per year are thought to be caused by falciparum malaria in Lombok alone, judging from the hospital data. According to the Gebrak Malaria Team in West Lombok, the annual incidence in the district of West Lombok from 1996 to 1999 was consistently over 40‰.
In the present report, we describe the small malaria endemic foci in the West Lombok and Sumbawa districts. Falciparum malaria is predominant over vivax malaria and other types of malaria. There are 11 species of Anopheles vector, but three of these species, An. subpictus, An. maculates and An. barbirostris, are of primary importance in malaria transmission and An. sundaicus and An. aconitus are of secondary importance. Our data from Sekotong, West Lombok, and Sumbawa supported the importance of An. subpictus in coastal areas but suggested the existence of different transmission peaks according to environmental conditions. The usual transmission peak comes in the dry season but is affected by climatic and geographical conditions. Although there were many malaria endemic foci along the coast, the width and grade of the foci varied widely. The presence of malaria endemic foci inland, although likely, has not been definitively reported to date.