日本医療経営学会誌
Online ISSN : 2187-8951
Print ISSN : 1883-7905
ISSN-L : 1883-7905
16 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
  • ―スタッフ看護師と管理者の比較―
    山口 久美子, 上田 理恵, 草刈 由美子, 田中 芳幸
    2022 年 16 巻 1 号 p. 5-13
    発行日: 2022年
    公開日: 2022/10/07
    ジャーナル フリー

    The purpose of this study was to clarify the relationship between bed control and the work environment of nurses working in Advanced Treatment hospitals. A questionnaire survey of 719 nurses and 57 managers working in the wards of one Advanced Treatment hospital was surveyed on anonymous self-administered questionnaires. As for the work environment, the correlation between 21 items and 7 items of bed control on the 3 subscales of the Japanese version of NWI-R was examined. The impact of items with significant correlation on the work environment was examined by multiple regression analysis. In addition, the impact on the work environment was examined by staff nurses and managers. The number of valid responses by staff was 598 (response rate: 95.5%), and the number of valid responses by managers was 46 (response rate: 97.2%). The results of multiple regression analysis showed that among staff nurses, "emergency hospitalization is natural when there are empty beds," "cooperation between wards," "discharge coordination," and "coordination with doctors" have positively significant influences related to the work environment. It was suggested that managers need to work on bed control in recognition of differences in evaluation with staff.

  • 中島 範宏
    2022 年 16 巻 1 号 p. 15-21
    発行日: 2022年
    公開日: 2022/10/07
    ジャーナル フリー

    Using the database of the medical accident collection of JCQHC (Japan Council for Quality Health Care), we analyzed 743 cases of suicide attempts from 2010 to 2020. In-hospital suicide attempts were common not only in patients with mental illness but also in cancer patients. Due to the refraining from seeing medical institutions due to the influence of Covid-19, there is concern that the disease of patients will become more serious, and it is necessary to provide psychological support to prevent the increase in the number of patients attempting suicide in the future.

    In addition, it is thought that the work environment of health care workers and lack of observation affect the occurrence of suicide, and if the discoverer is a nurse, it has a positive effect on the results after attempted suicide. Currently, reforms are required in the working styles of medical professionals, and it is expected that the number of patients' suicide attempts will decrease due to the improvement of the working environment of medical professionals.

総説
事例報告
  • ―その法人格の相違及び事業譲渡を視点として―
    坂本 泰祥
    2022 年 16 巻 1 号 p. 33-41
    発行日: 2022年
    公開日: 2022/10/07
    ジャーナル フリー

    In Japan, the number of home-visit nursing stations has rapidly grown in recent years, along with the number of users. Thus, it can be said that home-visit nursing stations are responsible for home care, which is a change in healthcare. Conversely, many industry restructurings through mergers and acquisitions (M&A) have occurred, and in addition, it seemed that home-visit nursing stations were also greatly affected by the new coronavirus infection. Therefore, this study aimed to analyze the impact of visiting nursing stations on management, and on other levels of nursing care. We analyzed their impact from viewpoints such as the adaptation process to environmental changes. In this article, the adaptation process referred to environmental recognition → judgment (management, nursing care level). Regarding the management level, the unique organizational characteristics of visiting nursing stations was considered. Various juridical personalities have joined home-visit nursing stations. This study also considered the contrast between the types of juridical personalities, as the adaptation process differed depending on them. Consequently, we were able to identify differences in the adaptation process between them. Furthermore, we conducted a multi-stage survey before and after the emergencies to analyze their impact and evaluate the trend of industry restructuring, which focuses on business transfer. As a result, we were not able to identify changes in both aspects before and after the emergencies.

調査報告
  • 元吉 晃太郎, 高瀬 浩造
    2022 年 16 巻 1 号 p. 43-47
    発行日: 2022年
    公開日: 2022/10/07
    ジャーナル フリー

    Hospitals are to observe various rules and norms. However, management resources are limited. To reveal the priority, we tried a qualitative research of newspaper reports about hospital compliance management. This research applied Grounded Theory to an issue of Fussa Hospital that an unclear process of stopping dialysis is concerned. This analytics revealed; ‘regret of a bereaved family’ was a trigger of the repots, ‘passion of journalism’ made the issue a big scoop and ‘a public investigation’ urged reporters to write about the issue as ‘raising an ethical issue’. In this case, mental and ethical considerations, not necessarily written social norms, are noted. Comparative investigations of other issues and direct surveys of public opinion are future challenges.

  • 杉田 英之, 真野 俊樹
    2022 年 16 巻 1 号 p. 49-57
    発行日: 2022年
    公開日: 2022/10/07
    ジャーナル フリー

    The purpose of this study is to see if women in their 30s and 50s who need to prevent postmenopausal osteoporosis can promote the change of preventive behavior of postmenopausal osteoporosis by using the healthcare smartphone app (hereinafter referred to as "healthcare smartphone app"). Whether people are using the healthcare smartphone app or not, it is to clarify the disease characteristics with other diseases. We conducted an Internet-based questionnaire survey of women in their 30s and 50s, received responses from 311 people. As a result, it was suggested that the use of health care smartphone apps can promote preventive behavior modification of postmenopausal osteoporosis. In addition, users of the healthcare smartphone app were strongly associated with postmenopausal osteoporosis prevention intentions, future health anxiety, and loneliness. Disease specificity with the menstrual cycle management app was confirmed. It is possible that incentives and gamification that encourage disease education, information provision, and continuation through healthcare smartphone apps are important for preventive behavior modification of postmenopausal osteoporosis.

  • ―協会けんぽデータによる分析―
    岡本 悦司
    2022 年 16 巻 1 号 p. 59-69
    発行日: 2022年
    公開日: 2022/10/07
    ジャーナル フリー

    Objectives: As the pandemic started in early 2020, WHO assigned a special emergency ICD-10 code to Covid-19. Japan followed it by assigning a special code for disease classification of health insurance claims. The author analyzed health insurance claims data to estimate health care cost spent for Covid-19.

    Methods: Japan Health Insurance Association (JHIA), provides aggregated claims data as open data. The JHIA data are aggregated by sex, age groups, prefectures, in/outpatient and, most importantly, disease classifications. JHIA enrolls approximately 35% of Japan's population younger than 75 years old. The author analyzed the JHIA data focusing on claims containing Covid-19 as principal diagnoses.

    Results: Approximately 101 billion yen were spent for approximately 2.4 million claims containing “Covid-19” code as their principal diagnoses. When applied to the national population, approximately 390 billion yen were spent for Covid-19 in 19 months (March 2020-September 2021), slightly less than 1% of Japan's national health care expenditures.

    Conclusion: Health insurance claims data may effectively be used as a supplement to the infectious diseases surveillance to monitor the utilization pattern of infected patients.

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