A study on the cost for medical education in university hospitals.

收集了5所大学医院的住院护理和费用的患者数据，并与其他综合医院的数据进行了比较。高校医院的医疗费用普遍高于综合医院，尤其是在检查、影像诊断和手术等方面，其原因是病例构成复杂，教育成本高，教育成本与每一项医疗操作密切相关，很难区分。目前，根据日本社会保险制度的计划，不支付这一教育部分的费用，即所谓的“间接费用”。针对高校医院医疗费用偏高的问题，应根据合理的信息进行分析，建立新的医师培训体系，通过对高校医院与综合医院医师心理行为差异的调查，明确高校医院医师重视病人的多样性和临床研究，在普通医院工作期间，他们非常重视病人的共同支付，并注意不被保险基金低估。

Patient data on hospital care and costs were collected from 5 university hospitals and compared with those of other general hospitals. Medical cost in university hospitals is generally more expensive than that of general hospitals especially in medical inspections, imaging diagnoses and operations because of the complicated case mix and the educational cost.The educational cost is tightly connected with each medical procedure itself, and it is very difficult to divide both components. At present, cost for this educational component, so called "indirect fee" is not paid under the scheme of Japanese social insurance system. Issues on higher medical cost in university hospitals should be analyzed based on reasonable informations and a new training system for medical doctors should be established.The survey on the psyco-behavioral differences of medical doctors between university hospital and general hospitals was carried out, and it has been made clear that physicians in the university hospitals attach imprtance on variety of patients and clinical research, and during the duty in general hopitals, they give much consideration for co-payment of patients, and pay careful attention not to be assessed down by the insurance fund.