| 抄録・内容（英） | In population declining society, what is needed for sustainability of regional medicine is the "suppression of isolated deaths", "optimal allocation of human resources for medical care provision", and "concentration of urban functions". I extracted issues from an advanced case study in Yubari City, Hokkaido, to see how medical professionals working in Japan perceive these issues, and analyzed a survey of attitudes about how to deal with them. Although measures to deal with a population decline and aging include a wide variety of social issues, this study focuses on the state of sustainable regional medicine and examines (1) medical issues faced in the past 10 years, measures taken and results achieved, (2) medical issues to be solved in the next 10 years, social issues that can be shared nationwide, and (3) measures to prevent regional medicine from reaching its limits as a common issue nationwide. As a method of verifying the state of regional medicine, I conducted a survey of the problem consciousness of practicing medical personnel in Yubari City, and extracted issues through holistic analysis using ethnographic methods. $ Firstly, "the outreach of regional medicine needs a major change (post-outreach) in the future," secondly, "the occurrence of isolated deaths cannot be controlled in communities where abandoned land is increasing and houses are scattered," and thirdly, "in the concentration of urban functions due to financial and human downsizing, sustainable medicine must be selected more minimally. As a result, the following issues were identified and examined: "Medical institutions that ensure regional medicine need to build up a 'system box' that can be maintained even if medical personnel are replaced"; "For isolated deaths, measures should be taken for early detection rather than suppression of the occurrence"; "Human medical resources should be focused on providing home medical care for terminal care patients rather than for patients who have difficulty going to hospitals"; "The results show that "settlements outside the urban function concentration area will gradually disappear. |
