【Survey Report】Over 60% of Medical Institutions Require Collaboration with Specialized Consultation Services for 'Solo Patients'

The Japan Medical and Nursing Care Business Federation (hereinafter referred to as JMNBF) conducted a questionnaire survey on the "full-scale initiation of 'solo patient' support" targeting medical institutions nationwide (73 valid responses). This survey revealed the actual situation of medical institutions' acceptance systems for patients without guarantors (so-called "solo patients") and the severe workload (shadow work) burden on on-site Medical Social Workers (MSW) and discharge support nurses. JMNBF will continue to build and implement/verify mechanisms to support "solo patients" across the entire community, collaborating with various stakeholders such as medical, administrative, nursing care, and private businesses.

## 【Survey Summary】
- While 58% of medical institutions unconditionally accept patients even without a guarantor, a strong sense of crisis is felt on site.
- The biggest challenge is the "workload burden due to shadow work of MSWs and discharge support nurses." This is followed by "unpaid medical bills" and "stagnation of bed control."
- For dealing with the "solo patient problem," 84% respond individually through "MSWs or discharge support nurses," indicating that organizational responses and the establishment of specialized consultation desks are not sufficiently advanced.
- Regarding private resources such as "Lifelong Support Services for the Elderly," negative images and lack of understanding are prevalent, with comments like "service content is incomprehensible" and "reliability of providers cannot be judged."
- The most frequently cited initiative for future consideration to solve the problem is "collaboration with specialized consultation services." 62% of responding facilities indicated they would like to consider "collaboration and cooperation with JMNBF."

## 【Survey Background】
With the advancement of a super-aging society and the increase in single-person households, responding to the hospitalization and discharge support of "solo patients" without guarantors has become a critical issue for medical institutions. However, response rules and social support systems are not adequately developed, and there are criticisms that the burden is concentrated on the front lines of medical institutions. This survey was conducted to understand the actual situation of medical settings and to serve as basic data for considering future collaboration and support systems.

## 【JMNBF's Insights and Future Developments】
From the results of this survey, it has become clear that responding to "solo patients" is not an issue that can be solved by medical institutions alone. Structural problems such as barriers in medical and nursing care collaboration and manpower shortages are factors hindering the realization of a community-based integrated care system.

Based on these results, the Japan Medical and Nursing Care Business Federation will strengthen the following initiatives:

- Promotion of understanding through in-hospital training and information provision for medical institutions.
- Establishment of networks connecting related organizations such as medical, administrative, nursing care, and private services.
- Implementation and verification of initiatives to solve on-site challenges.

JMNBF will contribute to protecting an environment where medical and nursing care professionals can concentrate on their original duties, and to realizing a society where even those without relatives can receive medical and nursing care with peace of mind.

## 【Survey Outline】
Survey Name: Questionnaire on the Full-Scale Initiation of 'Solo Patient' Support
Target: Medical institutions nationwide
Respondents: Management/administrative staff such as hospital directors, board chairpersons, and administrative managers
Number of Valid Responses: 73 facilities
Survey Period: Late January to early February 2026
Survey Method: Internet questionnaire