Sustainable Medical Care Systems in Areas with a Declining and Ageing Population: A Consideration of the Northern Part of Kyoto Prefecture as a Case Study

Abstract

In regional cities, human and material resources are ageing and heading towards decline. Continuing the competition among cities with the same living spheres simply because a neighbouring municipality built a facility will bring about the exhaustion of the area. The current state of affairs at public hospitals in regional cities is perhaps a prime example of this. This chapter examines the situation so far from the perspective of community healthcare. The location of hospitals with the municipality as the unit undermines the sustainability of medical care in the secondary medical area overall, as well as the existence of local communities. This chapter lays out the necessity of hospital reorganization to get the maximum out of economies of scale and of governance functions to make use of medical resources without waste.