[Current status and need for neurological practices from regional medical institutions].

We studied the current status of, and need for, neurological practices from regional medical institutions, including in-home services. These institutions classify patients with neurological diseases into three categories: cerebrovascular disease, intractable diseases, and other diseases with neurological symptoms. As acute and chronic neurological diseases run their course, patients require appropriate care, including diagnosis, treatment, rehabilitation, and in-home medical care. Rehabilitation is essential for patients with intractable or progressive disease because it helps to prevent progression, enhances mental health, and encourages the use of abilities that are unaffected by disease. As neurologists, we must consider how we can have a positive impact on the patient, the hospital, and the community. In Japan, the majority of patients who receive in-home medical care have neurological disorders, such as cerebrovascular disease or other intractable diseases. We have provided in-home support to 18 patients with amyotrophic lateral sclerosis who use ventilators. This year, a long-term care insurance system was instituted in Japan. Now, a support system needs to be established to provide community-based medical care, health care, and welfare services. As our population ages, we believe neurologists will play an increasingly important role in this support system.