{"created":"2023-06-19T10:05:02.393928+00:00","id":14321,"links":{},"metadata":{"_buckets":{"deposit":"50c46119-aa32-4167-819c-4c11528e0f0d"},"_deposit":{"created_by":18,"id":"14321","owners":[18],"pid":{"revision_id":0,"type":"depid","value":"14321"},"status":"published"},"_oai":{"id":"oai:kwmw.repo.nii.ac.jp:00014321","sets":["7:267:268"]},"author_link":["63391","63392"],"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":"Impact of Functional Differentiation among Hospitals on Regional Average Length of Stay"}]},"item_1_biblio_info_14":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2016","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"69","bibliographicPageStart":"59","bibliographicVolumeNumber":"26","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":"10.15112/00014287","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":"　これまで病院の機能分化を定量的に示す一般的な指標は存在しなかった．そのため，機能分化と医療の質や効率との関係については定性的な議論は行われても，定量的に分析する研究はあまり見られ なかった．そこで，市場の寡占状態を表す指標として用いられているハーフィンダール・ハーシュマ ン指数を拡張して，地域医療における病院の機能分化の程度を測る機能分化指数を考案した．本研究 では，この指標の有用性を検証することを目的として，この指標を用いて病院の機能分化が地域平均 在院日数に及ぼす影響について検討した．まず，地域平均在院日数と機能分化指数の関係を解析的に 求め，それを DPC（Diagnosis Procedure Combination）公開データに適用して検証した．その結果， 呼吸器系疾患や皮膚・皮下組織の疾患など多くの主要診断群において機能分化に伴って地域平均在院 日数が短縮傾向にあることが示された．その一方で，耳鼻咽喉科系疾患や新生児疾患，先天性奇形な ど，逆の傾向を示す主要診断群がいくつか見られた．本研究の意義は，機能分化と医療の質や効率と の関係を定量的に示すことができた点にある．考案した機能分化指数は DPC 公開データを用いて容 易に計算できるうえ，地域平均在院日数など地域の医療特性と密接な関係があるので，今後の地域医 療計画の進捗を評価するうえで客観的なデータの一つとして有用であると考える．\n"}]},"item_1_textarea_12":{"attribute_name":"抄録(英)","attribute_value_mlt":[{"subitem_textarea_language":"en","subitem_textarea_value":"　Due to the absence of generic indicators measuring the degree to which functions of healthcare service providers differentiate, there have been few researches which have analyzed the association between the functional differentiation and the quality and/or efficiency of healthcare quantitatively. Therefore a new indicator was developed by extending the Herfindahl-Hirschman Index which is a commonly accepted measure of market concentration. With the aim of verifying the usability of the indicator, an impact of the functional differentiation among hospitals in secondary medical service areas on the regional average length of stay (ALOS) in hospitals was investigated. After formulating an equation which describes the association between the indicator and the regional ALOS, the equation was validated with the diagnosis procedure combination (DPC) data publically available. As a result a reduction tendency of the regional ALOS was shown in many diseases such as diseases of the respiratory system and of the skin and subcutaneous tissue. On the other hand, an increasing tendency in some diseases, for example diseases of the ear and mastoid process and neonatal diseases and congenital malformations, could also be seen. Significance of the current study is to become able to show quantitatively the association between the functional differentiation and the quality and/or efficiency of healthcare. As the devised indicator can be calculated easily with DPC data and has a close relationship with regional healthcare characteristics, it was considered to be useful for evaluating a progress of regional health care planning."}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2016-12-09"}],"displaytype":"detail","filename":"07　田中昌昭.pdf","filesize":[{"value":"1.8 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"PDF","url":"https://kwmw.repo.nii.ac.jp/record/14321/files/07　田中昌昭.pdf"},"version_id":"718cc023-a245-45c6-a487-08108ad294ab"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"Herfindahl-Hirschman Index","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"functional differentiation","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"secondary medical service areas","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"ALOS (average length of stay)","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"DPC (diagnosis procedure combination)","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":"病院の機能分化が地域平均在院日数に及ぼす影響について","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"病院の機能分化が地域平均在院日数に及ぼす影響について"}]},"item_type_id":"1","owner":"18","path":["268"],"pubdate":{"attribute_name":"公開日","attribute_value":"2016-12-09"},"publish_date":"2016-12-09","publish_status":"0","recid":"14321","relation_version_is_last":true,"title":["病院の機能分化が地域平均在院日数に及ぼす影響について"],"weko_creator_id":"18","weko_shared_id":18},"updated":"2023-06-19T10:33:34.037110+00:00"}