「あんしんカード」を用いたがん患者の救急医療体制の 構築と病病・病診連携の試み

Oncologic Emergency Medical（OCM）card is to guarantee medical care to be provided by Tokushima Municipal Hospital to advanced cancer patients who once receive medical care in the institution even after they are referred to other hospitals or when their medical condition is worsened. Forty-seven cancer patients have been issued with the OCM card between April２０１５ and March ２０１６. For those patients, we have retrospectively investigated the actual medical services provided by our hospital and cooperation with other hospitals and clinics. The card was issued for ３８ patients who were under palliative treatment. More than half of all the patients issued with the card were in the department of surgery, and eight of them were colon cancer patients, who consisted the largest portion. Exacerbation of pain was the most common reason for those who used the card at the emergency outpatient visit, but more than half of them could return home within the same day. Although seven of fourteen patients who were determined to be under home care were eventually re-hospitalized, all the fourteen patients were able to spend as long time as possible at their own home due to the card system. During one year after the introduction of the OCM card system, there has been no trouble with the acceptance of emergency outpatient visits and the cooperation of Tokushima Municipal Hospital with other hospitals and clinics.