{"created":"2023-05-15T11:33:32.630314+00:00","id":4025,"links":{},"metadata":{"_buckets":{"deposit":"02ead406-d014-476f-ac6b-086c5213415d"},"_deposit":{"created_by":1,"id":"4025","owners":[1],"pid":{"revision_id":0,"type":"depid","value":"4025"},"status":"published"},"_oai":{"id":"oai:nsg.repo.nii.ac.jp:00004025","sets":["6:10:11:78"]},"author_link":["15194","15188","15195","15196","15186","15190","15187","15193","15191","15192","15185","15189"],"item_19_biblio_info_8":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2012-11","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"27","bibliographicPageStart":"17","bibliographicVolumeNumber":"12","bibliographic_titles":[{"bibliographic_title":"新潟医療福祉学会誌"}]}]},"item_19_description_16":{"attribute_name":"フォーマット","attribute_value_mlt":[{"subitem_description":"application/pdf","subitem_description_type":"Other"}]},"item_19_description_45":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"論文(Article)","subitem_description_type":"Other"}]},"item_19_description_6":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"In 2008 a new health care insurance system was introduced in Japan. Its main aim was to reduce doctors  office work, so that they could spend more time in hospitals. In order to verify the existence of the new insurance system in the Kanto and Shin-etsu districts, comparisons among respective preferences were performed by calculating the average number of medical administrative staff per 100 beds in general hospitals. Regional clustering was evaluated using  Moran s I   and bivariate local indicator of special association（LISA） was used to identify the hot spot, cold spots and outliers in 499 municipalities. The results showed that out of ten prefectures, Nagano prefecture was first on the scale. However, the hotspots were concentrated around the Tokyo metropolitan area. It was also noticed that the regional clustering in Nagano prefecture was quite different from other prefecture, as the level of contiguities with neighboring municipalities was low. The regional clustering in the Northern-Kanto district（ Tochigi, Gunma and Ibaraki prefecture） was not detected by this study.\n","subitem_description_type":"Abstract"},{"subitem_description":"平成２０年度の診療報酬改定で、病院勤務医師の事務作業の過度の負担を軽減し専門の医業に専念することを目的として傾斜配分方式の医師事務補助体制加算が導入された。本研究は、関東信越１０都県４９９市区町村において本加算を申請した病院の特性と市区町村での普及状況の地域集積性を関東地方厚生局管内の１０事務局からの情報公開データを用いて検証すること、更に同業務体制普及の地域差と新潟県の立ち位置を確認することを目的とした。解析の結果、長野県が病院の本加算の申請率（「加算採用病院率（％）」）と一般病床１００床当たりの医師事務補助者数（「１００床当医事補者数」）の両指標が最も高く、新潟県は前者が５位、後者は第９位であった。また管内の両指標の市区町村の分布には特徴ある地域集積性の存在が確認された。すなわち、首都圏は「加算採用病院率（％）」が高い自治体が地理的に集中しており、かつ「１００床当医事補者数」も同様に高い水準で分布していた。このため首都圏は二値LISA１）分布でみる地域集積性のパターンのうちHigh-Highの組合わせ（ホットスポット）地域であり病院間に競争原理が働いていることが示唆された。一方、両指標とも低いLow-Low（コールドスポット）地域は甲信越の県境付近に集中し、長野県の県平均は両指標とも１０都県中最大にもかかわらず地域集積性は低く、首都圏と異なりホットスポットを形成していないことが判明した。北関東（栃木県、群馬県、茨城県）は首都圏に隣接する一部を除き地域集積性が検出されなかった。","subitem_description_type":"Abstract"}]},"item_19_publisher_35":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟医療福祉学会"}]},"item_19_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AA11614531","subitem_source_identifier_type":"NCID"}]},"item_19_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"1346-8774","subitem_source_identifier_type":"ISSN"}]},"item_19_text_1":{"attribute_name":"Title in Japanese","attribute_value_mlt":[{"subitem_text_value":"関東信越厚生局管内病院の医師事務補助体制の地域集積性 : 医療保険「医師事務作業補助体制加算」を指標として"}]},"item_19_text_2":{"attribute_name":"タイトル（英）","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Regional clustering of medical administrative system of general hospitals under the jurisdiction of Kanto-Shinetsu Regional Bureau of Health,Labour and Welfare,Japan"}]},"item_19_text_47":{"attribute_name":"資源タイプ・NII","attribute_value_mlt":[{"subitem_text_value":"Journal Article"}]},"item_19_text_48":{"attribute_name":"資源タイプ・DCMI","attribute_value_mlt":[{"subitem_text_value":"text"}]},"item_19_version_type_18":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"瀧口, 徹"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"森脇, 健介"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"山本, 龍生"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"本間, 久文"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"東條, 猛"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"福島, 正巳"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Takiguchi, Toru","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Moriwaki, Kensuke","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Yamamoto, Tatsuo","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Homma, Hisafumi","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Toujo, Takeshi","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Fukushima, Masami","creatorNameLang":"en"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-10-30"}],"displaytype":"detail","filename":"017_027_w1202.pdf","filesize":[{"value":"1.2 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"017_027_w1202.pdf","url":"https://nsg.repo.nii.ac.jp/record/4025/files/017_027_w1202.pdf"},"version_id":"1ebe0c3a-5179-415e-bb7a-929059e8afc0"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"医師事務作業補助者","subitem_subject_scheme":"Other"},{"subitem_subject":"医療保険","subitem_subject_scheme":"Other"},{"subitem_subject":"地域集積性","subitem_subject_scheme":"Other"},{"subitem_subject":"空間的重回帰分析","subitem_subject_scheme":"Other"},{"subitem_subject":"競争原理","subitem_subject_scheme":"Other"},{"subitem_subject":"medical administrative staff","subitem_subject_scheme":"Other"},{"subitem_subject":"health care insurance system","subitem_subject_scheme":"Other"},{"subitem_subject":"regional clustering","subitem_subject_scheme":"Other"},{"subitem_subject":"spatial multiple regression analysis","subitem_subject_scheme":"Other"},{"subitem_subject":"principle competition","subitem_subject_scheme":"Other"},{"subitem_subject_scheme":"Other"},{"subitem_subject":"medical administrative staff","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"health care insurance system","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"regional clustering","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"spatial multiple regression analysis","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"principle competition","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"医師事務作業補助者","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"医療保険","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"地域集積性","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"空間的重回帰分析","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"競争原理","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"関東信越厚生局管内病院の医師事務補助体制の地域集積性 : 医療保険「医師事務作業補助体制加算」を指標として","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"関東信越厚生局管内病院の医師事務補助体制の地域集積性 : 医療保険「医師事務作業補助体制加算」を指標として"},{"subitem_title":"Regional clustering of medical administrative system of general hospitals under the jurisdiction of Kanto-Shinetsu Regional Bureau of Health,Labour and Welfare,Japan","subitem_title_language":"en"}]},"item_type_id":"19","owner":"1","path":["78"],"pubdate":{"attribute_name":"公開日","attribute_value":"2012-12-20"},"publish_date":"2012-12-20","publish_status":"0","recid":"4025","relation_version_is_last":true,"title":["関東信越厚生局管内病院の医師事務補助体制の地域集積性 : 医療保険「医師事務作業補助体制加算」を指標として"],"weko_creator_id":"1","weko_shared_id":1},"updated":"2023-05-15T23:15:17.009108+00:00"}