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二次医療圏を単位とした医療供給と受療行動の決定要因に関する研究

基于二级医疗领域的医疗供给与接受行为决定因素研究

基本信息

批准号：
09770273
负责人：
谷原真一
金额：
$ 1.22万
依托单位：
Jichi Medical University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Encouragement of Young Scientists (A)
财政年份：
1997
资助国家：
日本
起止时间：
1997 至 1998
项目状态：
已结题

项目摘要

国民健康保険全保険者のうち市町村保険組合の老人医療給付対象者における1人当たり費用などを1994年10月現在の時点で制定された342ヵ所の二次医療圏単位および都道府県を単位として分析した。説明変数として、産業別就業人口割合、1人当たり所得、医師数、病院一般病床数などを用いた。二次医療圏単位の情報が利用できない老人保健及び老人福祉に関する因子は都道府県単位でのみ分析した。二次医療圏単位でみた年間の老人1人当たり医療費は入院32.1万円、入院外26.7万円であり、最大値と最小値の格差は、入院医療費3.9倍、入院外医療費2.6倍であった。入院医療費を目的変数とした重回帰分析の結果、病院一般病床数、医師数及び三次産業就業人口割合、平均世帯人員及び1人当たり所得が有意とされ、これらの5変数により、入院医療費の変動の57.4%を説明できた。入院外医療費では、病院一般病床数、一次産業就業人口割合及び平均世帯人員が有意であり、これら3変数により入院外医療費の変動の21.4%を説明できた。都道府県単位でみた医療費の地域格差は、入院医療費2.4倍、入院外医療費2.0倍であった。重回帰分析の結果、病院一般病床数、二次及び三次産業就業人口割合、老人保健施設通所数、1人当たり所得が有意とされ、このモデルにより入院医療費の変動の85.1%が説明することができた。入院外医療費では、無床診療所数、医師数、被訪問指導実人員、特別養護老人ホーム定員及び基本健康診査受診率が有意とされた。これら5変数により入院外医療費の変動の53.4%が説明可能であった。二次医療圏を単位とした分析は都道府県単位よりも地域格差が大きい傾向にあった。これは都道府県内格差が考慮されたためと考えられる。

The National Health Insurance Department established a secondary medical care system for 342 elderly people in October 1994. Description: Number of employed persons by industry, income per person, number of doctors, number of general hospital beds, etc. The factors related to the health care and well-being of the elderly in the secondary medical system are analyzed in the provincial government. Second medical treatment period: 1 elderly person per year: 321,000 yen for admission, 267,000 yen for out-of-hospital treatment, 3.9 times for in-hospital treatment, 2.6 times for out-of-hospital treatment. Results of the analysis of the number of hospital medical expenses, the number of general hospital beds, the number of doctors and the employment population of three industries, the average number of people and the income of one person, the number of hospital medical expenses, and the change of 57.4% were explained. Out-of-hospital medical expenses, number of general hospital beds, primary industry employment population split and average number of people in the world, 21.4% of out-of-hospital medical expenses The regional difference in medical expenses in the prefecture is 2.4 times that of hospital expenses and 2.0 times that of hospital expenses. The results of the retrospective analysis showed that the number of general hospital beds, the employment population of secondary and tertiary industries, the number of elderly health care facilities, the income of 1 person, the change of hospital medical expenses, and 85.1% of the total income were explained. Outpatient medical expenses, number of bed-free clinics, number of physicians, number of people visited, number of elderly people in special care, and attendance rate for basic health examinations 53.4% of out-of-hospital medical expenses are accounted for. The second medical circle is divided into two parts: the first part is divided into three parts: the second part is divided into three parts: the first part is divided into three parts: the second part is divided into three parts: the first part is divided into three parts: the first part is divided into three parts: the second part is divided into four parts: the third part is divided into four parts: the fourth part is divided into This is the first time I've ever been to a hotel.