This study investigates the factors that balance hospital profitability with quality of care, focusing on hospitals that are accredited by the Japan Council for Quality Health Care (JCQHC) in Aichi prefecture. We estimate models explaining hospital revenue and profit between 2008 and 2010 with particular items related to the JCQHC as explanatory variables. We show that a high valuation of the nursing sector leads to higher hospital profits. In contrast, high valuations of financial accounting, budgetary control and business administration lead to lower hospital profits.

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The purpose of this study was to clarify head nurses' recognition of their “role” and “role behavior” through the classification of their management tasks. The study involved 20 head nurses with a mean age of 46.2 (SD±3.7) years. Their mean length of experience of the nurses as head nurses was 6.1 (SD±2.8) years. Their role behavior consisted of “role behavior as care providers,” “role behavior for organization management,” “role behavior for human resource management,” “role behavior as risk managers,” and “educational role behavior.” Characteristically, head nurses recognized “activities to secure human resources” not as “role behavior for human resource management,” but as “role behavior for organization management,” and “promotion of research and utilization of research results” not as their “role,” i.e., “quality assurance of nursing care,” but as “educational role behavior.” It was revealed that head nurses recognize the purpose of their management tasks in a way different from what it actually is, suggesting that opportunities to deepen explicit knowledge through research on nursing management and systematic education are indispensable, although it goes without saying that experience and education in nursing practice settings are important.

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The purpose of this study was to estimate the influence of the absence of pharmacists' inquiries about prescriptions on the treatment and length of hospital stay and the resulting health care costs, and thereby to evaluate the contribution of pharmacists' inquiries about prescriptions to the quality of care and their economic effects.
The study involved 148 cases of inquiries about prescriptions made by pharmacists during the 12-week survey period at a hospital in Tokyo. The Delphi method was used to increase the accuracy of estimating the influence of the absence of inquiries about prescriptions on the treatment and length of hospital stay, and the reduced health resource costs were evaluated on the basis of the sum of the individual health care costs.
The results revealed that the resultant increase in the length of hospital stay was 190 days, including prolongation of the length of hospital stay and the length of rehospitalization, in 43 cases. In addition, health care costs reduced by inquiries about prescriptions were estimated to be 750,000 to 1,900,000 yen. The contribution of inquiries about prescriptions could be quantified using health care costs, which confirmed the favorable contribution of pharmacists to the quality of care and medical economics.

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