Here we report the results of a long-term analytical study on the utilization of antihypertensive and antibacterial agents, which was performed using the Integrated Medical Information System (IMIS) developed by Kochi Medical School. The results indicate clear (increasing or decreasing) patterns in the numbers of patients and the dosages. Specifically, the total amount of antibacterials recently prescribed is significantly lower than in the year analysis began (1983). This reduction provides evidence of a steady improvement in the quality of medication and is particularly important for macrocosmic evaluation of the primary focus of our study, which was the “proper use of drugs”. Furthermore, the results also showed medication prescribed by non-specialists to be less inventive than that prescribed by specialists. This study highlights the importance of reforming institutions providing medical treatment from the perspective of effectively utilizing medical resources (by employing specialist personnel) and the proper use of medications. Because non-specialists prescribe medication in numerous medical facilities throughout Japan, these issues must be seriously considered.

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.