LAUSR

creating a matrix of the functions and organizations. Background: When a natural disaster or mass-casualty incident occurs, a large number of injured people visit hospitals. During these times, hospitals need to provide additional services. Thus, it is necessary for various related organizations such as hospitals, municipalities, medical associations, and trade associations, to collaborate. There is a pressing need to establish an Area Disaster Resilience Management System for Healthcare (ADRMS-H) to increase medical resilience. It is necessary to identify the functions of, and coordination between, organizations needed to develop ADRMS-H. Methods: We identified the medical care requirements during a disaster and the functions that guarantee ongoing health care by investigating disaster records and interviewing several doctors who provided health care services during the Great East Japan Earthquake. In addition, we analyzed the changes in the functions by the hour, and divided the phases based on the changes. Furthermore, we identified the organizations that are needed to fulfill each function and created a matrix between the functions and organizations of each phase. Results: We created the matrix based on each of the seven phases. The functions included those that must be fulfilled by hospitals, such as providing treatment, and those that must be fulfilled by municipalities, and so on, such as establishing aid stations. Some functions are fulfilled in cooperation with various organizations. Conclusion: When large earthquakes occurred in Japan, it was difficult to understand the functions needed to ensure continued health care services. Creating the matrix of each phase enables us to understand the changing roles of each organization by the hour. This facilitates in the establishment of ADRMS-H.