Basic Research on Reforming the University Hospital

本研究旨在厘清“医生继续教育”、“医学教学医院方式”等各种体制改革和临床新培训制度对大学医院的影响，并探讨未来大学医院的性质。在当前医生紧缺的环境下，构建高校医院与地区医院之间的循环教育体系是当务之急。今年（2008年），以山形县为对象，研究了医院病床和医生的适当安置。山形县的52个设施（不包括精神病医院）成为袭击目标。我们计算了医生人数与标准的比率，以及床位占用率。病床入住率以90%的数字来评价，这意味着良好的经营状况，而83.4%的数字在日本的医院中是平均水平。与日本的标准医生数量相比，对医生数量的满意度进行了评价。根据医生满意率和床位数入住率将符合条件的医疗机构分为四类。因此，不仅通过医生数量，而且通过比较医院床位占用率和医生满意度，我们可以区分出优先强化医疗的机构和应该放弃的机构。希望该评价方法能对构建高校医院与地区医院之间的循环教育体系有所帮助。

The purpose of this study is to clarify the situation, influenced by various institutional reforms and new clinical training system on "continuing education of doctors" and "ways of teaching hospitals of Medicine", and to examine the nature of a university hospital in the future. In the current environment of shortage of doctors, medical training system to build a cycling education program among university hospital and regional hospitals is essential intensification. In this year (2008), targeting Yamagata Prefecture, the proper placement for the hospital beds and physicians was studied.Fifty-two facilities excluding psychiatric hospitals in Yamagata Prefecture were targeted. We calculated the ratio of the number of doctors to the standard, and bed occupancy. The bed occupancy rate was evaluated by number of 90% that means good business condition, and 83.4% that was average in the hospitals in Japan. The satisfaction of the number of doctors was evaluated comparing to the standard number of doctors in Japan. Eligible medical institutions were classified into four groups based on doctor satisfaction rate and bed occupancy rate.As a result, not only by the number of doctors but also by comparing the hospital bed occupancy and doctor satisfaction, we can distinguish between institutions intensified medical priorities first and institutions that should be relinquish.We hope that this evaluation method can help build cycling education system between university hospital and regional hospitals.