日本医療経営学会誌
Online ISSN : 2187-8951
Print ISSN : 1883-7905
ISSN-L : 1883-7905
12 巻 , 1 号
選択された号の論文の8件中1~8を表示しています
巻頭言
原著
  • 松本 尚, 原 義明, 齋藤 伸行
    2018 年 12 巻 1 号 p. 5-14
    発行日: 2018年
    公開日: 2018/10/03
    ジャーナル フリー

    Purpose: Income from a university hospital can be an important source of revenue for a medical university. However, at private medical schools, it is difficult to secure this revenue due to several external environmental factors. This paper discusses a strategy for profitability that private medical schools could employ to enable them to continue to deliver high-quality medical education in a difficult economic environment.

    Methodology: To evaluate medical school financial situation, 11 medical schools were selected from among 82 medical departments. Financial indicators were collected and calculated on a per-bed basis. Values for these variables were compared between private universities and national or municipal universities.

    Results: There was a strong positive correlation between the number of beds and medical income. However, increasing the number of beds did not contribute to an increase in ordinary profit. When drawing an approximate curve of the ordinary profit ratio and the number of beds, the profit ratio peaked at between 1,500 and 1,700 beds.

    Conclusions: This study indicates private medical schools should consider reviewing the number of their university hospital beds. To maximise investment in medical education, it is essential to ensure sound university hospital operation and university management, and this research is expected to provide a basic policy.

  • 石川 雅俊
    2018 年 12 巻 1 号 p. 15-19
    発行日: 2018年
    公開日: 2018/10/03
    ジャーナル フリー

    An exploratory analysis focusing on provision of medical and nursing care was conducted, regarding the main causes related to the percentage of home death within municipalities in order to prepare the basic material for promoting the Community-Based Integrated Care System in Japan.

    The result of multiple regression analysis with percentage of home death as dependent variable showed that while the population density (per area of permanent residence), the number of users of visiting nursing, the number of clinics to be checked at the general clinic, the number of nursing staff, and the number of general clinics to do care recognized a significant positive relationship, number of hospitals, number of group homes, number of health care expenditures per person (National Health Insurance), number of establishments of visiting nursing, number of elderly health care facilities, number of elderly welfare facilities, number of beds in community inclusive care wards, average life expectancy Admitted a significant negative association.

    The result for the most part was in line with previous studies that with municipalities as subjects. This research is a ecological study, and in order to consider development of more accurate models, we need to analyze data including socio-economic factors, and individual situations.

  • 中島 範宏
    2018 年 12 巻 1 号 p. 21-27
    発行日: 2018年
    公開日: 2018/10/03
    ジャーナル フリー

    At the great east Japan earthquake, numerous victims were forced to live as evacuees for an extended period of time, and it is estimated that the medical needs of those with chronic afflictions exceeded the need for medical care immediately following the disaster. There is a possibility that the citizen possesses a certain amount of chronic disease medicine at hand, but there are no studies that clarified the viewpoint of medical professionals about the pros and cons of the citizen's own medicines stockpile for disaster. So we conducted a questionnaire survey on medical supplies prepared for disasters for physicians and pharmacists. Secondary disaster risks at the time of natural disasters in their workplaces were high. Therefore, it was suggested that public stockpiling should be carried out in a safe place. It is necessary to discuss the risks and benefits of each medicine stockpiling method for each medical area.

  • 石川 雅俊
    2018 年 12 巻 1 号 p. 29-33
    発行日: 2018年
    公開日: 2018/10/03
    ジャーナル フリー

    This study was aimed to analyze the relationships between average travel times to perinatal medical centers and maternal mortality rate from the perspective of secondary medical districts in Japan, by using a geographical information system.

    After tallying the maternal mortality rate (per 100,000 births) during the period from 2005 to 2014 at the secondary medical districts, the presence or absence of maternal mortality in secondary medical districts was set as an explanatory variable; the results of binomial logistic regression analysis in which the number of births was added to the explanatory variable to adjust the population revealed that based on secondary medical districts with mean driving time of less than 15 minutes, secondary medical districts of 15 minutes to less than 30 minutes were significantly more likely to be a cause of maternal mortality (P <0.05). By contrast, for secondary medical districts of 30 minutes or longer, the possibility of maternal death is low, albeit no statistical significance was noted.

    The results of the present study indicate the possibility that the maternal mortality rate increases as the driving time from the house of the pregnant woman to perinatal medical center becomes longer, suggesting that in order to ensure a safe and reliable perinatal medical care system, it may be necessary ensure that pregnant women have proper access to perinatal medical centers.

事例報告
  • 山村 淳哉
    2018 年 12 巻 1 号 p. 35-44
    発行日: 2018年
    公開日: 2018/10/03
    ジャーナル フリー

    The purpose of this study is to discover factor and mechanism that is effective for financing improvement as an example by Saitama Prefectural hospital reform. For the profit improvement of the then Saitama Prefectural hospital, the quantitative result of both improvements of the profit and reduction of the expense was confirmed. Measures for medical quality improvement by the managers caused an autonomous action for the management improvement of the medical person, and helped profit improvement indirectly. On the other hand, by reduction of the internal cost, short-term result was given. The trust of the manager increased and was able to thereby reduce outsourcing expense. In conclusion, while a manager made much of a cost cut from the viewpoint of management efficiency, he thought about improvement of the medical quality to the first. And it gathered followers of the medical person.

  • 根本 康子, 林 重雄
    2018 年 12 巻 1 号 p. 45-53
    発行日: 2018年
    公開日: 2018/10/03
    ジャーナル フリー

    We constructed an SPD system using RFID (Radio Frequency Identification) that uses radio waves allowing identification of individual items, in order to reduce hospital expenditure by restructuring the methods for purchasing and supplying medical materials for surgery, and in order to increase treatment safety by improving the traceability of medical materials. Making medical materials traceable enabled us to find out their usage status, and standardized and improved the efficiency of the insurance billing process, and improvements to the method of supplying medical materials made operating room work more efficient and reduced stock levels. However, issues remain, including the question of how to deal with items that become unidentifiable due to being mistakenly discarded, the scope of medical materials to which RFID tags should be applied, and the method to use for applying tags.

調査報告
  • 阪口 博政, 荒井 耕, 高瀬 浩造
    2018 年 12 巻 1 号 p. 55-62
    発行日: 2018年
    公開日: 2018/10/03
    ジャーナル フリー

    The purpose of this study is to clarify the accounting education programs for hospital department manager. We interviewed 4 hospital managers in 2016 - 2017, specifically 2 top managers who graduated from a management school and 2 middle managers in charge of providing a systematic education program for management. As a result, it became clear that when making organizational considerations, the department managers are required to have knowledge of basic financial accounting to read financial statements and to analyze them. It also mentioned that regarding departmental considerations, the managers are required to have knowledge of the basics of management accounting, especially breakeven point analysis. However, it seems that each organization requires a different scope of knowledge based on the organizational policy between the medical stuff and administrative staff.

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