A Study on the Streamlined Management Method for the University Hospital Based on the Clinical Demand and Supply Data from Time Study in the Ward

为了探讨一所大学医院的精简管理，1999-2002年在大阪大学医院外科病房进行了以下研究：临床时间研究；(1)医疗供需平衡的评价；(2)患者医疗需求的指标和模型的建立；(3)合理供给的有效测量和制定；(4)临床病房时间研究数据精度的提高；(5)护理和医疗工作分类的智能时间研究数据库的开发。医疗需求和供给平衡的公式是一个概念模型，包括患者的观察因素和供应量以及预期(理想)需求。将代表患者需求的指标分为患者来源状态数据和医生处方来源(用于治疗或临床化验)患者状态数据两类。利用上述两种数据集(r&gt；0.91)，通过回归分析和多水平分析，很好地估计了医务人员为患者提供的总时间的医疗服务供应量。

In order investigate on the streamlining of a university hospital management, following studies have been carried out during the year 1999-2002 with the examination of clinical time study at the surgical ward in Osaka University Hospital ; (1) the evaluation of the medical demand and supply balance, (2) the development of adequate index and model for the patient's medical demand, (3) the contrivance of effective measure and formulation for appropriate supply, (4) the improvement of data precision of the time study in the clinical ward, (5) the development.of intelligent time study database for classification of nursirig and medical job.A formulation of medical demand and supply balance was presented as a conceptual model including observed factors and amounts of supply and expected (ideal) demands of a patient. The indexes representing the patient's demand were classified into two types of the patient's information, one was the patient's origin status data and the other was the doctor's prescription origin (for treatment or clinical laboratory test) patient's status data. The medical care supply incorporated as a total time offered by medical stuffs to the patient was well estimated by regression analysis and multi-level analysis using above two types of datasets )r>0.91).