日本医療経営学会誌
Online ISSN : 2187-8951
Print ISSN : 1883-7905
ISSN-L : 1883-7905
最新号
選択された号の論文の9件中1~9を表示しています
原著
  • 〜全国の産婦人科勤務医への意向調査から〜
    石川 雅俊
    2021 年 15 巻 1 号 p. 5-13
    発行日: 2021/08/31
    公開日: 2021/09/25
    ジャーナル フリー

    Physicians' knowledge acquisition and skill improvement have relied on individual efforts. The Ministry of Health, Labour and Welfare has indicated the guidance of physicians' self-improvement and “working hours”. I conducted a web-based questionnaire survey of obstetrics and gynecology physicians who worked in hospitals nationwide and investigated the physicians' attitudes regarding self-improvement and “working hours”.

    The questionnaire was sent to 893 hospitals, and valid responses were obtained from 919 obstetricians and gynecologists from 343 hospitals (response rate: 38.4%). Based on the types of self-improvements indicated by the Ministry of Health, Labour and Welfare (which is not considered to be “working hours” in principle), the percentage of obstetricians and gynecologists who answered that they were "accepted now" or "should be accepted" as “working hours”, excluding "studying for graduate school exams." were over the majority. The result revealed that there was a large gap between the institutional interpretation and the doctor's intentions regarding self-improvement and “working hours”.

  • 石川 雅俊
    2021 年 15 巻 1 号 p. 15-22
    発行日: 2021/08/31
    公開日: 2021/09/25
    ジャーナル フリー

    Introduction: The shortage of anesthesiologists and their geographical maldistribution are major issues facing Japanese health care policy. This study aimed to examine the distribution and retention patterns of anesthesiologists, define the factors contributing to their retention.

    Method: A longitudinal retrospective study based on a secondary national survey analysis was carried out. I performed a descriptive study to identify anesthesiologists' retention patterns between 1996 and 2016. I then used a multivariable logistic regression analysis to test the variables associated with the retention of anesthesiologists.

    Results: The total number of anesthesiologists in Japan increased by 82% between 1996 and 2016. The results also showed an increasing inequality in their distribution between urban and rural areas. The anesthesiologists' annual retention rate from 2014 to 2016 was reported to be 89.8%, reflecting an improvement of 3.7% during the study period. The chances of continuing to practice as an anesthesiologist were higher a) with 15–29 years of experience, b) working at an academic and other hospitals, and c) working in the intermediate geographical region.

    Discussion: Although the number of anesthesiologists in Japan increased rapidly between 1996 and 2016, their geographical maldistribution also increased. The low number of anesthesiologists in rural areas may contribute toward the insufficient number of surgeries performed in rural areas.

  • 中島 範宏
    2021 年 15 巻 1 号 p. 23-30
    発行日: 2021/08/31
    公開日: 2021/09/25
    ジャーナル フリー

    We conducted a questionnaire survey of care workers about how to store drugs in case of a disaster. Many respondents said that the cost of stockpiling for disasters should be borne by the national and local governments. In addition, many home-use medicines such as lifestyle-related diseases, psychotropic drugs, and cold medicines were mentioned as medicines to be stockpiled. However, the involvement of doctors and pharmacists is important because long-term care workers have limited control over the medicines of those in need. Many respondents said that they should stockpile if there is the risk of secondary disasters around the workplace. However, depending on the type of secondary disaster such as a tsunami or fire, it is difficult to stay in a long-term care facility, so the effectiveness of stockpiling drugs is questionable. There is also a previous study recommending that stockpiled supplies be stored in evacuation shelters, and there is room to consider stockpiling and managing medicines in highly safe evacuation shelters.

  • 串田 ゆか, 本間 利通
    2021 年 15 巻 1 号 p. 31-36
    発行日: 2021/08/31
    公開日: 2021/09/25
    ジャーナル フリー

    Revision of the Act on Securing Quality, Efficacy and Safety of Products Including Pharmaceuticals and Medical Devices and establishment of community-based integrated care systems are driving reforms in the job performed by pharmacists. As a result, along with pharmacist recruitment, pharmacist job redesign is now a significant issue. It is essential to analyze the factors that promote job crafting, which is organizational behavior in which pharmacists (and other workers) voluntarily redesign their jobs. This study measures job crafting among pharmacists and conducts a preliminary examination of its significance. Specifically, we confirm the correlations between the three components of job commitment and the four components of job crafting. As an improvement to the measurement scale, we propose dividing the job-crafting domain into two categories, "interpersonal" and "non-interpersonal," to properly categorize the different types of work performed by pharmacists.

  • 山口 久美子, 草刈 由美子, 上田 理恵, 田中 芳幸
    2021 年 15 巻 1 号 p. 37-43
    発行日: 2021/08/31
    公開日: 2021/09/25
    ジャーナル フリー

    The purpose of this study is to compare the intention of hospital nurses to leave their jobs and the working environment before and after the reorganization. Valid responses (valid response rate) were assumed to have no missing values. In 2013 before the reorganization, 106 people (67.3%) were analyzed, and in 2014 after the reorganization, 73 people (61.9%) were analyzed. There was no significant difference in the intention to leave the job before and after the reorganization. The nursing work environment was highly evaluated before the reorganization. However, the evaluation was low after the reorganization, and a significant difference was observed before and after the reorganization. We believe that analyzing and responding to the workplace environment evaluation after the reorganization will lead to improvement of the workplace environment.

調査報告
  • 荒井 耕, 古井 健太郎
    2021 年 15 巻 1 号 p. 45-51
    発行日: 2021/08/31
    公開日: 2021/09/25
    ジャーナル フリー

    These days, many clinics pursue ancillary business diversification. Therefore, it is important for community-based integrated care system to pay attention to sustainability of these clinics. It is required for sustainability evaluation to analyze effect of diversifications on not only profitability but also financial soundness. This study verifies the effect on financial soundness by regression analysis, where each type of diversifications are chosen as explanatory variables, and corporate characteristics such as economic scale are used as control variables.

    Compared with care planning support only, many types of diversification providing care services have significant negative effects on financial soundness in terms of equity ratio and avoidance of insolvency. Especially, diversification combining care with elder care facility, diversification combining care planning, care and elder care facility, diversification combining day care with elder care facility, and diversification combining four types of ancillary businesses have strong negative impact on equity ratio and avoidance of insolvency.

  • 松田 良子
    2021 年 15 巻 1 号 p. 53-62
    発行日: 2021/08/31
    公開日: 2021/09/25
    ジャーナル フリー

    In this paper, we comparatively analyzed the data on initial actions and situations of the major European countries related to COVID-19. As a result, it has become clear that government policy and medical system in each country have a significant impact on the number of infections person and dead person. It has also been revealed that lockdown content and timing will affect the spread of the infection. Lockdown should be implemented more strictly before the spread of infection. As for the medical system, it became clear from the data that a full medical system would lead to the recovery of patients. And more, early PCR tests are more effective. It should also be known all over the world that it is important to conduct antigen tests as soon as a new type of virus will occur.

  • – 改組1年目と2年目の比較 –
    山口 久美子, 草刈 由美子, 上田 理恵, 田中 芳幸
    2021 年 15 巻 1 号 p. 63-68
    発行日: 2021/08/31
    公開日: 2021/09/25
    ジャーナル フリー

    The purpose of this study is for nurses working in reorganized hospitals, regarding human attributes, willingness to leave work, job satisfaction, and nursing work environment (Japanese version of NWI-R) in the first and second years after reorganization. Is to make a comparison. The contents of the question are personal attributes, intention to leave the job, job satisfaction, and nursing work environment. The valid respondents (valid response rate) were assumed to have no missing values, and 73 (61.9%) were analyzed in the first year of reorganization and 107 (79.3%) in the second year of reorganization. As a result, in the comparison between the first year and the second year after the reorganization, the intention to leave the job in the first year was high, and the job satisfaction and the Japanese version of NWI-R were evaluated low and a significant difference was observed. The importance of organizational management in the first year of reorganization became clear.

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