Basic Research on Reforming the University Hospital

本研究的目的在于厘清“医师继续教育”与“医学教学医院方式”受各种制度改革与新临床训练制度影响的现况，并探讨未来大学医院的性质。在当前医生短缺的大环境下，构建大学医院与区域性医院之间的循环式医学教育体系势在必行。本年度（2008年），以山形县为对象，对山形县内除精神病院以外的52个设施的病床和医师的适当配置进行了研究。我们计算了医生人数与标准的比率，以及床位占用率。病床占用率通过90%的数字进行评估，这意味着良好的业务状况，而日本医院的平均水平为83.4%。与日本的医生标准数量相比，对医生数量的满意度进行了评价。将符合条件的医疗机构按医生满意度和床位使用率分为四类，结果，不仅按医生数量，而且按床位使用率和医生满意度进行比较，我们希望这种评估方法能帮助建立大学医院与大学医院之间的循环教育体系，区域医院。

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.