Purpose：To clarify factors related to changes in activities of daily living (ADL) among elderly patients who were discharged to home.

Methods：The subjects were 88 persons who received in-hospital musculoskeletal rehabilitation and discharged to home. Factors related to changes in functional independence measure (FIM) score were examined.

Results：The factors related to restoring the FIM score to its values before hospitalization were frequency of physical exercise at 1 week (odds ratio [OR] ＝1.41) and 1 month (OR＝1.27) after hospital discharge, restoring the FIM score at hospital discharge to its value before hospitalization (OR＝3.96), and feeling of self-efficacy (OR＝1.16) at 3 months after hospital discharge. A receiver-operating characteristic analysis revealed that the factors related to restoring the FIM score to its value before hospitalization were frequency of physical exercise (cutoff value＝1.5) at 1 week after discharge, frequency of physical exercise (cutoff value＝1.0) at 1 month after discharge, and feeling of self-efficacy (cutoff value＝31.5) at 3 months after discharge. In addition, ≥ 2 days of physical exercise per week after hospital discharge was more likely to lead to high FIM score than ＜ 2 days of physical exercise per week.

Conclusion：Our results implied that regular physical exercise soon after hospital discharge would lead to better prognosis

[Objective]In this study, we examined the relationship between public subsidies for acupuncture and moxibustion therapy, which are established independently by municipalities that serve as agents for National Health Insurance, and group health level indices such as life expectancy and health care costs that are incurred due to the treatment of illnesses.
[Methods]Eighty-five municipalities in Fukuoka Prefecture that serve as agents for National Health Insurance were the subjects of this study. "The upper limit of subsidy funds available for acupuncture and moxibustion therapy per year"was calculated from the limits of the subsidy systems that were established independently by each municipality. We then examined the relationship between this value, health indices (life expectancy and standardized mortality rate), and health care costs (actual health care costs per person for inpatient and outpatient care for the treatment of illnesses).
[Results]A significant positive correlation was observed between public subsidy funds for acupuncture and moxibustion therapy and life expectancy (males:r = 0.53, P < 0.001, females:r = 0.44, P < 0.001), whereas a significant negative correlation was observed for standardized mortality rate (males:r =-0.48, P < 0.001, females:r =-0.34, P < 0.005). Furthermore, a significant negative correlation was observed between public subsidy funds for acupuncture and moxibustion therapy and health care costs (inpatient:r =-0.26, P < 0.05, outpatient:r =-0.30, P < 0.05).
[Conclusion]Most patients who use acupuncture and moxibustion therapy seek treatment primarily for symptoms involving the musculoskeletal system. The fact that life expectancy is higher when subsidy funds are greater may be considered to be caused by improvements in daily living, increased physical activity due to relief of musculoskeletal disorders through acupuncture and moxibustion therapy, and reduced risk of fatal disease (such as cancer, ischemic heart disease, and cerebrovascular disorders). It also suggests the possibility that acupuncture and moxibustion therapy inhibit the severity of fatal diseases or the conditions that may cause these fatal diseases.

[Objective]The purpose of this study is to investigate a situation of practitioner-patient risk communication about acupuncture and moxibustion treatment.
[Methods]The subjects of this study were 250 Fukuoka City Acupuncture and Moxibustion Association's members and their 1,250 patients in Japan. The practitioner and patient questionnaires included the same items, with the same response categories.
[Results]Ninety-one practitioners (36.40%) and 407 patients (32.56%) returned questionnaires. The 'practitioner better'situation (i.e. when practitioners'evaluations were better than patients'evaluations) had the most negative influence on patient outcome measures compared with the other situations. For the explanation of medical testing, 'length of clinical experience'[OR 1.30, 95%CI 1.00 to 1.68]was a significant predictor of the practitioner-better situation. For the explanation of treatment, 'length of clinical experience'[OR 1.05, 95%CI 1.02 to 1.08]was a significant predictor of the practitioner-better situation. Most patients (73.21%) had not been asked about acupuncture and moxibustion therapy use by their physician. Twenty-seven (48.21%) patients informed their physicians about acupuncture and moxibustion therapy use. Five (4.00%) side effects were reported. The side effect occurred regardless of a practitioner and patient characteristics, and did not influence the patient's outcomes.
[Discussion]It is thought that obtaining knowledge is useful in the architecture of a person for future better practitioner-patient relations.

OBJECTIVEAlthough many studies have shown the usefulness of influenza vaccine in elderly in-patients, the efficacy of vaccination with regard to the daily physical activities of patients has not been fully evaluated. To address this issue, we correlated the use of medical resources with vaccination status in patients categorized according to their daily activity levels.

METHODSThe subjects comprised 237 in-patients at or above 51 years of age, who were hospitalized in the long-term care unit of a Japanese hospital between January and March, 1999. The vaccination status and medical resources use (i.e., oral antibiotics, injected antibiotics, blood cell count, chest X-ray) of each patient were recorded, and the patients were assigned to three subgroups, based on daily life activity scores.

RESULTSVaccinated in-patients in the 'bed-bound' category required fewer medical resources, i.e., oral antibiotics (-2.29 days,P<0.05), injected antibiotics (-5.02 days,P<0.001), blood cell counts (-4.66 times,P<0.001), and chest X-rays (-4.31 times,P<0.001), compared with unvaccinated in-patients. There were no significant differences in treatment parameters between vaccinated and unvaccinated patients in the 'partly limited' or 'no limitation' categories.

CONCLUSIONSIt is suggested that influenza vaccination significantly reduces the need for medical treatment only among those in-patients who are the least physically active. Further studies are required to replicate these findings, and to elucidate the underlying reasons for this reduction.

The number of acupuncturists and moxibustion therapists has rapidly increased since around 2000. If they can be regarded as new healthcare resource investments, it is of great significance to evaluate their social impact. Here, we conducted a regional correlation study in different prefectures by using the extension of average life expectancy as an evaluation index. The results revealed an increase in “acupuncturists (human healthcare resources)” and in “facilities for performing acupuncture and moxibustion therapy (physical healthcare resources)” to show a weak but statistically significant positive correlation with the extension of average life expectancy for elderly men. Due to methodological limitations, however, this study cannot confirm a causal relationship between them. The author strongly hopes that public service corporations involved in the provision of acupuncture and moxibustion will henceforth serve as a bridge to allow researchers, acupuncturists, and moxibustion therapists to collaborate and conduct multicenter joint studies, in order to create an even greater social impact of acupuncture and moxibustion.