As a management improvement tool useful for cost containment and adaptable to the trend of reform in recent years, we introduced the SPD system of medical materials. Since there had been no precedent for the introduction of the SPD system in the hospitals affiliated with Kouseiren and even for the dealer it was the first trial, an original system was built. The quantity of materials in stock was fixed by entrusting, so-called the shelf control system. This system has been left in charge of one hospital employee and one individual employed by the dealer.The condition at the time when this system was introduced was not to increase personnel but to lower costs. The maintenance costs of this system were as cheap as 137,700 yen per month on a five-year lease. As a result, the quantity of inventory at the time of the term-end settlement of accounts reduced by about 18 million yen. Moreover, in marked contrast with increased income, the amount of money expended in the purchase of medical materials decreased from that in the pervious year. Though the number of items used in each department has increased by 480 items now from the start, the inventory is 0 yen.This system is very useful especially for the inventory management of specific insurance medical materials, because it can take in insurance claim data on MO (Magneto Optical Disk), compare it with the purchase data of materials and check the income-and-expenditure balance of specific insurance medical materials immediately. The sum of the amount of temporary stock curtailment for the past two years and six months and the annual purchase curtailment amount was 93,380,000 yen.It is concluded that the introduction of the SPD system has contributed much to the improvement of inventory management.
Insurance ; System ; Reduction - action ; Effective ; Original

To prevent protein-energy malnutrition in elderly inpatients with dysphagia, weexamined the current meals for them in detail. The thickeners seemed to be a ploblem. Changes of viscosity over time and temperature were reduced when a starch thickener was changed to a xanthan gum thickener. When a gelatinizer was added to soft meals to allow cutting into shape, etc., the meals looked better were less sticky, more cohesive, and easier to eat. Thus, the smooth texture required of meals for dysphagia patients was obtained. When conventional mixed meals were changed to soft meals, there was an improvement of appearance and the meals became more palatable.The change of food intake after these improvements was investigated in five inpatients who had difficulty in swallowing. Food intake was increased in four of these five patients after these improvements, suggesting that their appetite might have been increased by improvement of the appearance and palatability of their meals. We will continue making improvements of these meals in hopes that patients can eat solid food again as early as possible.
Deglutition Disorders ; Eating ; Energy, Physics ; Solid ; Malnutrition

In order to carry out mass examination for detection of stomach ailments effectively and improve screening accuracy, the Nagano Prefectural Welfare Federation of Agricultural Cooperatives, with its mass gastric examination committee as a driving force, has made every endeavor in close collaboration with Federation-affiliated hospitals.
The ratio of those receiving detailed examination to the total number of those who have undergone mass screenings, and the detection ratio of gastric cancer cases, especially those in early stages, have increased steadily over the past years.
This is due in the main to untiring effort exerted by public health nurses and other persons concerned with health problems.
However, the results of X-ray examination made on the basis of the diagnostic standards prepared by the Federation show that there is much need of improving examiners' ability to read mass miniature radiographs correctly.