Journal of the Japan Society for Healthcare Administration
Online ISSN : 2185-422X
Print ISSN : 1882-594X
ISSN-L : 1882-594X
Volume 47, Issue 2
Displaying 1-6 of 6 articles from this issue
PERSPECTIVE
RESEARCH NOTES
  • Mitsuko ONDA, Yoshihiko HIROTANI, Yukio ARAKAWA
    2010 Volume 47 Issue 2 Pages 61-68
    Published: 2010
    Released on J-STAGE: November 15, 2010
    JOURNAL FREE ACCESS
    The status of the use of antimicrobials for the treatment of pneumonia was benchmarked by using diagnosis procedure combination (DPC) data, and the effects from the use of antimicrobials on the financial aspects of hospitals were examined. For each period of hospitalization, the percentage of patients who brought greater income to the hospital through the introduction of DPC, increase-decrease ratios (comprehensive payment/payment based on performance) and the percentage of payment for each medical action to the total payment based on performance were comparatively evaluated. Furthermore, a survey was made on the trends in the use of antimicrobials, payment based on performance and the average for the total expense for injections for each segment of hospitalization, the percentage of the total payment for injections to the total payment based on performance (hereafter “injection ratio”), and the increase-decrease ratio. The comparative evaluation covered the correlation between the use of antimicrobials and increase and decrease in hospital revenue.
    When the trend in the use of antimicrobials was compared according to the length of stay at hospitals, changes were noted with the course of hospitalization in each hospital. It was also noted that the ratio in injections given is inversely related to the greater increase-decrease ratios in these hospitals. Thus, it was suggested that according to the DPC codes, the trends in the use of antimicrobials have effects on the financial management of hospitals.
    Download PDF (345K)
  • Yasuko OGATA, Midori NAGANO, Midori NISHIOKA, Tomoko AKANUMA, Akiko UC ...
    2010 Volume 47 Issue 2 Pages 69-80
    Published: 2010
    Released on J-STAGE: November 15, 2010
    JOURNAL FREE ACCESS
    The purpose of this study is to make a preliminary investigation on the reliability and validity of the Practice Environment Scale of the Nursing Work Index, PES-NWI (Japanese version). Self-reporting questionnaires were sent by mail to 665 nurses working at 6 hospitals in Japan. There were 282 (42.4%) responses.
    The reliability of the subscales and a composite measure of the PES-NWI were supported by the Cronbach's alphas and correlation coefficients between the pair answers reported twice. Cronbach's alphas were 0.90 for composite, 0.76-0.86 for the subscales, and the correlation coefficients based on the test-retest method were 0.65-0.83.
    Content validity of the PES-NWI was confirmed. The subscales and a composite were related to certain variables including nursing satisfaction (P<0.05). Factorial validity of the 3 subscales such as “Staffing and Resource Adequacy” and “Collegial Nurse-Physician Relations” was high, although the 2 subscales did not indicate a factorial separation. Construct validity will require further investigation by using the PES-NWI that includes a more variety group of subjects in future studies.
    Download PDF (407K)
  • —— A survey on the attitudes of guardians by using a contingent valuation method (CVM) ——
    Takumi TANIKAWA, Hisateru OHBA, Katsuhiko OGASAWARA, Tsunetaro SAKURAI
    2010 Volume 47 Issue 2 Pages 81-91
    Published: 2010
    Released on J-STAGE: November 15, 2010
    JOURNAL FREE ACCESS
    Techniques in telemedicine system have advanced lately and its introduction into pediatric emergency care is expected. For the present study, a questionnaire survey was conducted with the guardians of children by employing the contingent valuation method (CVM) to elucidate the needs of area residents for utilizing telemedicine system in the early emergency care of children. In the survey, the guardians' willingness to pay (WTP) for the use of a tele-consultation system was investigated by asking the amount one would be willing to pay out-of-pocket for each use of the system. In particular, the study included comparisons among the attributes of respondents and that between two areas in Hokkaido with different distances to reach medical resources. The results of the analysis indicated that there was no significant difference in the WTP due to the distance to reach medical resources, indicating that the need for a tele-consultation system is not dependent on the distance to medical facilities. In the comparison of the respondents' attributes, on the other hand, WTP tended to be higher in those groups with only one child, with a greater income, and who possess knowledge of telemedicine.
    Download PDF (695K)
  • Yuki KUWAHARA, Satoko NAGATA, Atsuko TAGUCHI, Sachiyo MURASHIMA
    2010 Volume 47 Issue 2 Pages 93-101
    Published: 2010
    Released on J-STAGE: November 15, 2010
    JOURNAL FREE ACCESS
    The purpose of this study was to clarify what kind of work a visiting nurse (VN) did for pre and post discharge. Seven patients in six stations who discharged in October and November of 2007 were targeted. We conducted self-recorded time study to investigate how long VN station staffs spend on the works for seven patients in six stations, and interviewed VN station staffs for further information about their works.
    We found that VN station staffs not only visited patients' home but did a various kind of work. The contents of timing of work depended on the patients' medical condition, whether they had used the VN station before or not, or whether discharge planning had been done for them during initial hospitalization. As to the post discharge works, the time to contact other agencies was longer for the patient who had been discharged to home without any support or when the patient was in the terminal phase of the disease, compare to the time for other cases.
    When the fee schema for VN service is discussed, patients' condition and the VN's amount of work on pre and post discharge must be taken into consideration.
    Download PDF (345K)
SYMPOSIUM
feedback
Top