{"created":"2023-06-19T10:05:00.843825+00:00","id":14281,"links":{},"metadata":{"_buckets":{"deposit":"598efc97-6089-42ab-a90f-47a01822c257"},"_deposit":{"created_by":18,"id":"14281","owners":[18],"pid":{"revision_id":0,"type":"depid","value":"14281"},"status":"published"},"_oai":{"id":"oai:kwmw.repo.nii.ac.jp:00014281","sets":["7:257:265"]},"author_link":["63291","63292"],"item_1_alternative_title_20":{"attribute_name":"その他(別言語等)のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"On the Size Distribution of Hospitals: Empirical Study and Stochastic Model"}]},"item_1_biblio_info_14":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2016","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"294","bibliographicPageStart":"281","bibliographicVolumeNumber":"25","bibliographic_titles":[{"bibliographic_title":"川崎医療福祉学会誌"}]}]},"item_1_creator_6":{"attribute_name":"著者名(日)","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"田中, 昌昭"}],"nameIdentifiers":[{}]}]},"item_1_description_1":{"attribute_name":"ページ属性","attribute_value_mlt":[{"subitem_description":"P(論文)","subitem_description_type":"Other"}]},"item_1_description_2":{"attribute_name":"記事種別(日)","attribute_value_mlt":[{"subitem_description":"原著","subitem_description_type":"Other"}]},"item_1_full_name_7":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{}],"names":[{"name":"TANAKA, Masaaki"}]}]},"item_1_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.15112/00014249","subitem_identifier_reg_type":"JaLC"}]},"item_1_publisher_23":{"attribute_name":"公開者","attribute_value_mlt":[{"subitem_publisher":"川崎医療福祉学会"}]},"item_1_source_id_13":{"attribute_name":"雑誌書誌ID","attribute_value_mlt":[{"subitem_source_identifier":"AN10375470","subitem_source_identifier_type":"NCID"}]},"item_1_source_id_19":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0917-4605","subitem_source_identifier_type":"ISSN"}]},"item_1_text_22":{"attribute_name":"その他(別言語)の雑誌名","attribute_value_mlt":[{"subitem_text_value":"Kawasaki medical welfare journal"}]},"item_1_text_9":{"attribute_name":"著者所属(日)","attribute_value_mlt":[{"subitem_text_value":"川崎医療福祉大学医療福祉マネジメント学部医療情報学科"}]},"item_1_textarea_11":{"attribute_name":"抄録(日)","attribute_value_mlt":[{"subitem_textarea_value":"　地域における医療資源の適切な配置や行政機関による地域医療計画の策定において医療提供体制の現状を正確に把握することは不可欠である．従来から厚生労働省が実施している医療施設調査を利用すれば，都道府県別の病床数や病床規模別の病院数を把握することはできる．しかしながら，これらの調査で分かるのは設備としての病床規模で，しかも10～100床刻みの大雑把なものである．綿密な医療政策の実現に必要なのは，病床数ベースの病院規模ではなく，むしろ実際の患者数ベースの病院規模で，しかも疾患領域別に病院規模を把握できるのが望ましい．そこで，厚生労働省が公開しているDPC（Diagnosis Procedure Combination）データを用いて，疾患領域別・都道府県別に退院患者数で見た病院のサイズ分布を調べた．その結果，多くの場合，病院のサイズ分布が幾何分布になっていることがわかった．その原因を解明するために単純な確率モデルを構築してコンピュータシミュレーションを行った．そのシミュレーション結果と確率モデルの解析によって，患者が病院を選択するときに，病院までの距離を優先した場合は二項分布，病院の規模（症例実績）を優先した場合は対数正規分布，そして両方を考慮した場合は幾何分布になることが示された．これらの傾向は，実際のDPC データを用いて確認された．従来，病院のサイズ分布にはあまり関心が寄せられてこなかったが，本研究は，疾患領域別や都道府県別に病院のサイズ分布を初めて明らかにしただけでなく，病院のサイズ分布を幾何分布や対数正規分布などのパラメトリックな分布関数で表現できるようにした最初の研究でもある．これにより，医療政策や医療評価に必要な諸量を統計的に計算することができるようになるため，これまで以上に精緻な病院規模別の各種分析や統計処理を行うことが可能になる．"}]},"item_1_textarea_12":{"attribute_name":"抄録(英)","attribute_value_mlt":[{"subitem_textarea_language":"en","subitem_textarea_value":"　It is necessary to make an accurate understanding of the current state of the healthcare delivery system for the proper placement of regional healthcare resources and for the formulation of a regional healthcare plan. Indeed we can obtain the number of hospitals by the number of beds using the health statistics provided by the Ministry of Health, Labour and Welfare (MHLW), however, these tell us not only hospital size as facilities but rough data on a 10 to 100 beds basis. The true necessity for the realization of in-depth medical policies is not the facility-based hospital size but the patient-based hospital size. So the author investigated the size distribution of hospitals by prefecture and disease domain measured by the number of discharged patients using the Diagnosis Procedure Combination (DPC) data. As a result in most cases the size distribution of hospitals turned out to be geometric distribution. In order to elucidate the mechanism, a simple stochastic model was build and computer simulation was conducted. By the results of the simulation and the analysis of the stochastic model, it was shown that the size distribution of hospitals will be binomial when patients prefer the distance to hospitals to be short, and will be log-normal when they prefer the size of hospitals (the number of cases of disease) to be large, and will be geometric when they take into account the both. These tendencies were confirmed to be consistent with DPC data. While the size distribution of hospitals had not received great attention in the past, the current research not only clarifies it in detail but also represents it in a parametric distribution function such as geometric or log-normal for the first time. Herewith a variety of quantity necessary for a medical policy and a medical evaluation can be calculated statistically which will make various analysis and statistical works more elaborate than ever."}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2016-04-26"}],"displaytype":"detail","filename":"05　田中昌昭.pdf","filesize":[{"value":"1.6 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"PDF","url":"https://kwmw.repo.nii.ac.jp/record/14281/files/05　田中昌昭.pdf"},"version_id":"56743711-22cd-479c-96c8-5908573e6dde"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"size distribution of hospitals","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"stochastic model","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"DPC (diagnosis procedure combination)","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"geometric distribution","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"computer simulation","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"病院のサイズ分布について：実証研究と確率モデル","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"病院のサイズ分布について：実証研究と確率モデル"}]},"item_type_id":"1","owner":"18","path":["265"],"pubdate":{"attribute_name":"公開日","attribute_value":"2016-04-26"},"publish_date":"2016-04-26","publish_status":"0","recid":"14281","relation_version_is_last":true,"title":["病院のサイズ分布について：実証研究と確率モデル"],"weko_creator_id":"18","weko_shared_id":18},"updated":"2023-06-19T10:33:59.119033+00:00"}