The Ministry of Health, Labor, and Welfare of Japan have suggested local governments establish Health, Medical, and Welfare Coordination Headquarters at the time of disaster. Gathering and processing information is one of the key functions of the headquarters. The study aims to clarify the required functions of information for the headquarters.

A series of interview surveys and observations were conducted, including for local governments and experts in disaster response. The contents were analyzed and required standard functions and procedures had been extracted.

The most important aspect of information gathering is its use in decision-making in matching needs and demands with resources. Needs and demands are based on damage and situation of the casualties. Resources can be categorized into human, material, financial, and informational. Because the headquarters have to process much information, it is important to clarify the objective and strategy of disaster response. The headquarters gather various quantitative and qualitative information using information and communication technology, telephone, meeting and other methods. Qualitative information can be categorized as: expected, surprising (unexpected), and unusual (rare) contents. For expected contents, quantification or estimation of needs from information in normal time or limited information immediately after the disaster and displaying or further analyzing by geographic information systems is useful. By surprising contents or case reports, additional responses or strategies will need to be reviewed.

The procedure, including information gathering and decision-making, follows the OODA (observe, orient, decide, act) loop. According to our mail survey of all 47 prefectural local governments in 2019, 89% were planning to establish the headquarters. However, only 36% had prepared a manual. Using the results of this study, a standard strategic manual for the operations of the headquarters is being developed and brushed up.

Loss of patient information can hinder medical care for evacuees and the reconstruction of medical facilities damaged by major incidents. In Japan, health insurance coverage is universal, and information about diagnoses and health care services provided is shared by the medical facilities, Health Insurance Claims Review and Reimbursement Services or the National Health Insurance Organization (NHIO), and the insurers. After the Great East Japan Earthquake on March 11, 2011, we interviewed officers in charge of NHIO in the 3 prefectures that were damaged by the earthquake and elicited how they assisted with medical care for evacuees and reconstruction of the damaged medical facilities.

Comprehensive interviews were conducted with officers in charge of the NHIO in the 3 prefectures to obtain information about the use and provision of health insurance claims data 3 to 4 months after the event. We then analyzed the official data concerning use of the information from the claims in chronological order.

The NHIO headquarters in the 3 prefectures were not physically affected by the disaster, and their information on the health insurance claims was intact. Patient information acquired before the disaster was obtained from the health insurance claims and applied to the medical care of the evacuees. The information also was used to reconstruct patient records lost in the disaster.

The information that was obtained from health insurance claims was used to improve medical care after the large-scale disaster. (Disaster Med Public Health Preparedness. 2013;0:1–5)

The disruption of routine treatment, including the interruption of medication, exacerbates chronic conditions during disasters. However, the health consequences of the interruption of medication have not been fully examined. On 22 July 2006, a flash flood affected more than 3,000 households in five cities and four towns in the northern part of Kagoshima Prefecture in southwest Japan. The aims of this study are to describe the prevalence of the interruption of medication among the outpatients in the flood-affected area and to determine the risk and preventive factors for the interruption of medication.

This was a cross-sectional study using a self-administered questionnaire. The study subjects were the outpatients who visited nine of 15 medical facilities in the flood-affected area from 23 January and 31 January 2007. Of 810 valid respondents, 309 who received medication treatment before the event were eligible for the study. Information on socio-demographic factors, chronic health conditions, preparedness-related factors before the event and damage-related factors were collected. Overall and evacuation status-specific prevalence of interruption of medication were presented. For those evacuated, the associations between interruption of medication and relevant patient characteristics, as well as deterioration of health status after the event, were examined.

The prevalence of interruption of medication was 9% in total, but it increased up to 23% among the evacuated subjects. Interruption of medication was more likely among those aged ≥75 years (odds ratio [OR] = 3.6; 95% confidence interval [CI] = 1.0−12.6) and those receiving long-term care services (OR = 4.6; 95% CI = 1.1−19.1), while it was less likely among those with hypertension (OR = 0.2; 95% CI = 0.1−0.8) and those prepared to go out with medication (OR = 0.2; 95% CI = 0.03−0.8). Those who experienced interruption of medication were more likely to have deteriorated health status one month after the event (OR = 4.5; 95% CI = 1.2−17.6).

Interruption of medication occurred more commonly among the evacuated subjects. Among the evacuated, the elderly and those receiving longterm care services were at high risk for interruption of medication, while the preparedness behavior of “preparing to go out with medication” had preventive effect. Special attention must be paid to the high-risk subgroups, and some preventive behaviors should be recommended.