機能ユニット統合システムの視点から考察した院内開業方式による自治体病院改革の有効性

抄録

As a result of a case survey of Ashiya hospital to verify effectiveness of municipal hospital reform by the in-hospital practice method, two facts are revealed. First, this reform is recognized effective for all of Ashiya hospital, a clinic unit, and patients. Ashiya hospital improved the sickbed occupancy rate, and also remarkably reduced degree of deficit because it was enabled to add up commissions and rent followed by the hospital and clinic cooperation. The clinic unit lowered the initial cost and has many introduced patients, which results in good financial status. The patients reduce the access burden and medical expenses. Secondly, in order to succeed the in-hospital practice, it is recognized that it is indispensable to construct an integrated management structure. However, the current medical system works as an obstructive factor to prevent sharing the entrance, the reception, the waiting room, and so on by a hospital and a clinic unit. The in-hospital practice method is effective, and a flexible system operation needs to be approved in order to develop to other hospitals hereafter.