HPH for Oslo

1. Health Impact
by joining “Tomo” group
Japan
Mimihara General Hospital
Department of General Medicine
Daiju Ueda
(SAMURAI)

2. Health Impact
by joining “Tomo” group
Japan
Mimihara General Hospital
Department of General Medicine
Daiju Ueda
(SAMURAI)
Zelkova Tree
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4. “Tomo” group in our hospital.

5. Our hospital and patients
have benefited a lot from “Tomo”.

6. “Tomo” group decreases the death rate.
Our hospital and patients
have benefited a lot from “Tomo”.

8. What is “Tomo” ?

9. What is “Tomo” ?
“Tomo” means “Friend”

10. What is “Tomo” ?
Community
“Tomo” means “Friend”

11. What is “Tomo” ?
Develops high Social Capital
(from 1953)
Community
“Tomo” means “Friend”

12. Hospital
Residents Patients
What is “Tomo” ?
(from 1953)
Tomo
Health Care Centre

13. Hospital
Residents Patients
What is “Tomo” ?
(from 1953)
Tomo10€ forever/household

14. What is “Tomo” ?
(from 1953)
Residents Patients
Tomo
Hospital
Health promotion Discounthealthcheck

15. Residents Patients
Tomo
Hospital
Supports our hospital Patients retention
What is “Tomo” ?
(from 1953)

16. Residents Patients
Tomo
Hospital
Study meeting
Visit each other
What is “Tomo” ?
(from 1953)

17. What is “Tomo” ?
(from 1953)
Hospital
Residents Patients
High Social CapitalHealth promotion
Patients retention
Study meeting
Visit each other
Supports our hospital
Discounthealthcheck

18. 355,240 households
(March 2015)
About 2000 new households/year
“Tomo” group

20. We have never researched the benefits.
Background

21. Abstract
We researched the difference of the death rate
in our hospital between Tomo group patients
and the other in fiscal 2013.

22. Inpatients
8704 patients
57%
50%
4388 patients
fiscal 2013
Mimihara General Hospital
Outpatients
119689 patients
Tomo
non Tomo

23. Death
505 patients
50%
37%
187 patients
fiscal 2013
Mimihara General Hospital
Inpatients
8704 patients
Tomo
non Tomo

24. Method
Multivariable logistic-regression models
were prepared to estimate the odds ratio and
95% confidence interval about the death rate
between Tomo group patients and the other.
ついいけるか？
視覚的に.

25. Main Results
The death rate of patients in Tomo group was
lower than the others and its OR was
0.6180(95% CI: 0.530 to 0.7590, P value<0.01)

26. Results
Multivariate statistics
Factors Odds Ratio 95% CI P value
Tomo 0.6180 0.530-0.7590 <0.0001
Univariate statistics
Factors All Death P value
Group Tomo 4316 320 <0.0001
non Tomo 4388 189
Housemate Solitary 1548 109 0.03
not Solitary 6790 338
Sex Male 4424 298 0.0007
Female 4280 211
Age <75years old 5914 206 <0.0001
≧75years old 2790 303
Days in the hospital ≦14days 6813 272 <0.0001
>14days 1887 237

27. Assessment
There is a significant difference the death rate
in the hospital between Tomo and non Tomo.
Patients belongs in Tomo are less likely to die
in our hospital.

28. Assessment
The acute care hospitals provides intensive
care. And take over patients to chronic care
hospitals who turned in chronic phase.

29. Assessment
It’s preferable to die not in the acute care
hospitals for patients and hospitals.

30. Assessment
“Tomo”group patients may be highly health-
conscious so that they had no need to entering
acute care hospitals when they die.

31. If other hospitals would start similar groups to
our Tomo group, similar benefits to the health
of patients would be promoted elsewhere.
For the future

33. Limitation
This research could be improved by more
data points as a factor of Multivariable
logistic-regression.

34. For the “Tomo”members…

35. Thank you.
Japan
Mimihara General Hospital
Department of General Medicine
Daiju Ueda
(SAMURAI)