Background: This study aimed to evaluate the relationship between disease type and healthcare-seeking behavior in patients in order to assess the role of primary care in rural areas of Japan.
Methods: National Health Insurance receipt data were collected for outpatients from four towns in Hokkaido, Japan. Disease names were encoded using the International Classification of Primary Care-2 (ICPC-2) coding system. Patient data were divided into two categories: those visiting medical facilities in their own towns and those visiting medical facilities in other towns.
Results: The percentage of patients who visited medical facilities outside their own town ranged from 42.9% to 72.7%; the mean value for all four towns was 54.6%. The three most frequent ICPC-2 codes according to the reimbursement receipts were K86 (hypertension, uncomplicated), T93 (lipid disorder), and T90 (diabetes, noninsulin dependent), and patients with T90 visited facilities in other towns more than those with K86 and T93. Patients with diseases of the eye, such as F91 (refractive error), F92 (cataract), and F71 (allergic conjunctivitis), and those with psychological disorders, such as P76 (depressive disorder), tended to visit facilities outside their towns rather than in their own towns.
Conclusions: Data regarding patients who visit medical facilities in their own towns may provide information on the role of primary care in that particular town. The analysis of medical reimbursement receipts from a particular area provides useful information about disease distribution in addition to an overview of the healthcare needs of the entire community in that area.

Introduction: We conducted a nationwide questionnaire survey for care managers (CMs) regarding their awareness about the role of pharmacists in home medical care, and objectively analyzed the obtained data using text mining.Methods: Survey targets were CMs belonging to the Japan Care Manager Association (JCMA). A letter of request was mailed to the 47 prefectural branches of the JCMA. Only members of the JCMA who agreed to participate in this survey responded.Results: Responses were received from 206 CMs, 25% of whom had experience as medical professionals and 75% whom had experience as nursing care welfare staff. 90% of the 206 CMs replied "They are necessary" to the question "Are pharmacists necessary for home medical care?". Using text mining to identify the reason for answering "They are necessary", the characteristic keywords from the CMs with experience as medical professionals were "instruction" and "internal use". On the other hand, the characteristic keyword from the CMs with experience as nursing care welfare staff was "consultation".Conclusion: The CMs with experience as medical professionals expected the pharmacists "to demonstrate their expertise to patients, families, and other professionals". On the other hand, the CMs with experience as nursing care welfare staff expected the pharmacists "to provide consultation on information about medications and side effects".

Object : Through understanding feelings of residents in the face of the large-scale rationalization of medical resources and their views about the new system of community medicine, we clarify how we should streamline community medicine along the opinion of residents living in local areas.
Methods : We interviewed some residents in the face of the economic collapse in X city. Through the interviews, we qualitatively analyzed their feelings that they had concerning the large-scale rationalization of medical resources and their views about community medicine in the future.
Results : We found three common themes with regard to how to streamline community medicine along the residents' opinions : the way of the rationalization of medical resources, the state of community medicine, and the attitude of the municipal government and medical institutions.
Conclusion : To carry out streamlining community medicine, it is important for the municipal government and medical institutions to take account of residents' opinions more seriously in the process and the content of the rationalization of medical resources, and to understand the social background of the community and residents' feelings more deeply.