開設者別に見た一般病院の平均在院日数の年次推移:─1971年から2014年までの変化─  [in Japanese] Annual changes in the average length of stay at general hospitals by founder:──Changes from 1971 to 2014──  [in Japanese]

Access this Article

Author(s)

Abstract

<p>1980年代以降の病院の平均在院日数の短縮化は,一般的には,診療報酬の点数誘導によるものと見なされているが,個々の病院の施策への反応はさまざまである。開設者別に一般病院の平均在院日数の年次推移を長期的に辿り,施策との間に何らかの関連性を見出すことができるかを検討した。</p><p>病院報告の1971年から2014年までのデータを用いて,ジョインポイント回帰分析を行ったところ,在院日数は開設者ごとに異なる変遷を辿っていることが明らかになった。また,基本史料から在院日数に関わる施策を抽出して傾向をまとめところ,高齢者の長期ケアを分離する施策と,在院日数短縮に経済的インセンティブを与えて急性期ケアへ誘導する施策という二つの大きな流れに分けることができた。</p><p>在院日数の年次推移に関しては,医療法人において他との違いが際立っており在院日数の変曲点に相当する施策も複数見出されることから,施策に強く反応した可能性が示唆された。</p>

<p>Since 1980s, the average length of stay of inpatients at hospitals has become shorter. In general, it is considered that the duration of hospitalization is influenced by the fee points for medical service;however, responses to policies vary from hospital to hospital. We followed, for a long period of time, and evaluated the annual changes in the average length of stay at general hospitals by founder to determine if the length of stay was associated with the policies in some way.</p><p>We performed a join-point regression analysis using data from hospital reports between 1971 and 2014. The results revealed that the changes in the length of stay indeed varied by the founder of the hospital. In addition, we randomly sampled policies associated with the length of stay from basic historical materials to summarize the tendencies. The results showed two major tendencies:policies not applicable to long-term care for elderly, or policies including provision of financial incentives to shorten the length of stay to promote shift to acute-phase care.</p><p>In regard to the annual changes in the length of stay, medical corporations showed marked differences from other founders. Since multiple policies corresponding to inflection points of the length of stay were found, we concluded that medical corporations possibly had strong responses to policies.</p>

Journal

  • Journal of the Japan Society for Healthcare Administration

    Journal of the Japan Society for Healthcare Administration 55(1), 19-26, 2018

    Japan Society for Healthcare Administration

Codes

  • NII Article ID (NAID)
    130006701656
  • Text Lang
    JPN
  • ISSN
    1882-594X
  • Data Source
    J-STAGE 
Page Top