| Objectives. In recent years, health centers (HCs) and Prefectural Institute of Public Health (PIPH) are creating community health information systems. To what extent the goals of the systems have been achieved has not yet been assessed. Thus, the objective of study was to investigate whether or not the network among municipalities, HCs, and PIPH has been established for the provision and analysis of health indicators by focusing on the use of health indicators for making Health and Welfare Plan for the Elderly (HWPE).; Method. The author conducted literature review of and in-depth interview at PIPHs in Tokyo Metropolis and Ishikawa Prefecture to study the process of setting up community health information systems. The author also conducted a survey with a structured questionnaire on the person in charge of HWPE in each of 90 municipalities and the person in charge of health information in each of 73 health centers in Tokyo and Kanagawa Prefecture. The questionnaire to the municipalities included the questions such as what health indicators they used for making HWPE, what indicators they would like to use in the future, and what kind of support they received from HCs in the planning process. The questionnaire to HCs included questions such as mortality indicators that they mainly calculate, surveys on the elderly, support for the municipalities. The author also investigated the availability of mortality data in the vital statistics in Tokyo and Kanagawa.; Results. Both PIPHs formulated a plan of integrated health information system and created a database of mortality statistics as a part of it. The system in Tokyo maintains the mortality data by 47 prefectures and 13 areas for secondary care within Tokyo, while that in Ishikawa does so by 41 municipalities within the prefecture. Ministry of Health, Welfare, and Labor annually provides Tokyo Metropolis, Kanagawa Prefecture, and the cities designated by ordinance with the number of death in each municipality by sex, age group, and causes. However, neither every municipality received them nor did it have a system to maintain it. (Abstract shortened by UMI.)... |
