日本建築学会計画系論文集
Online ISSN : 1881-8161
Print ISSN : 1340-4210
ISSN-L : 1340-4210
ある地方都市における公立二次医療機関の再編・再配置による要支援・要介護高齢者の通院距離の変化
西野 辰哉田中 智也
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ジャーナル フリー

2018 年 83 巻 751 号 p. 1679-1686

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 1.Objective
 This study verifies that the outgoing distance to hospitals for elderly people has changed as a result of the re-organization/ re-allocation of public hospital facilities closer to the central point of a local city's elderly population. We considered the effects of the re-organization/re-allocation on a district with the city's largest elderly population as well as a densely populated elderly district that is part of a relatively rapidly aging middle mountainous spa town.

 2.Study Method
 We ran simulations based on comparisons between survey findings on the actual outgoing distance to hospitals for elderly people before re-organization and additional survey findings after re-organization.

 3.Results and Discussion
 When a public hospital was relocated from the old city center area to the new city center area, around 90% of the outpatients followed. When a public hospital in the middle mountainous spa town was converted to a public clinic, about 30% of the outpatients changed their routine to go to the new public hospital in the new city center area. We also saw an increase in the eight-district weighted average of the outgoing distance to hospitals for care-requiring seniors. The scanty number of subjects sampled, however, casts doubt on the reliability of the fact-finding results.
 Next, we simulated variations in the outgoing distance to hospitals for care-requiring seniors surveyed before and after the re-allocation of public hospital facilities. When it was postulated that all of the people in the middle mountainous spa town who had attended the old public hospital regularly would go to the new public clinic, a significant decrease was seen in the eight-district weighted average of the outgoing distance to hospitals. But when it was postulated that all of the people who had attended the old public hospital regularly would change their routine to go to the new public hospital, the eight-district weighted average of the outgoing distance to hospitals increased.
 Accordingly, we judge the re-organization as appropriate since some functions of the old public hospital in the middle mountainous spa town carried over into the new public clinic. Furthermore, when it was postulated from the fact-finding results that 30% of the regular attendants at the old public hospital in the middle mountainous spa town would change their routine to go to the new public hospital in the new city center area, the eight-district weighted average of the outgoing distance to hospitals showed significant decreases as well as scattered increases within an error range.
 From the above, we have concluded that the rate of change in the eight-district weighted average of the outgoing distance to hospitals depends on the concentration of care-requiring people attached to the old city center area and on the proportion of outpatients from the old public hospital in the middle mountainous spa town who switch to the new public hospital in the new city center area.

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