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Cooperation in infection control has been implemented in the HOKUSHIN region, the northern area of Nagano prefecture, since 2007. The health insurance systems have required inter-hospital cooperation before additional charges can be accepted since 2012, so we examined the eŠects of this change on infection control activities in each hospital in our network. Twenty ˆve of the 37 hospitals in our region (67.6) replied to our questionnaires about acceptance of additional charges and the state of cooperation. Acceptance of additional charges had increased remarkably in middle size hospitals, and future acceptance was indicated in many small size hospitals. However, the actual costs for infection control activities will increase in the future in many hospitals. We recommend continuous expansion of our regional network and the development of cooperative activities for infection control in Hokushin. Key wordslocal network, infection control team (ICT), medical fee, additional charge for infection control

Effect of Additional Charges for Infection Control in the Regional Network of Northern Nagano