超高齢社会における地域包括ケアシステムとリハビリテーション科医の役割―臨床から地域・エビデンスづくりまで

Roles of the Rehabilitation Physician and Community General Support System in a Super-Aged Society : From Clinical Practice to Community Care and Creation of Scientific Evidence

はじめに

　超高齢社会に備えるため地域包括ケアシステムの整備が打ち出された．その背景と概要を確認し，リハビリテーション（以下，リハ）とリハ科医の役割を考える．結論を先取りすれば，第1に，限られた財源の最適配分のためのエビデンスづくり，第2に，臨床医として目の前にいる一人の患者に関わる役割だけでなく，地域づくりや予防的リハへの貢献が求められる．現在までに得られている地域づくりによる一次予防の重要性を示すエビデンスや地域介入研究を紹介する．

Abstract : The establishment of a community general support system is proposed in order to prepare for a super-aged society. In this paper we review the background reports and overview of the system and we discuss the expected role of rehabilitation and physicians trained in rehabilitation medicine. In summary, we are expecting the following : firstly, to create scientific evidence to facilitate appropriate allocation of limited financial resources, secondly, for clinical physicians to not only be actively involved with patients in front of us, but to also contribute to develop a healthy and active aging community wherein the prevention of disability is foremost. Finally, some evidence from tertiary and secondary prevention care and an intervention trial aimed to develop a healthy and active aging community as primary prevention are introduced.