Departmental Bulletin Paper 〈論文〉関西地域における医療の生産性について

鈴木, 善充

[要旨]本稿では, 関西地域における医療の生産性の現状を, 病院の規模と機能分化が進んでいるかという2点で検討をおこなった. 本稿でわかったことは以下のとおりである. 第1に, 日本において, 90年代前半から現在にいたるまで医療供給体制は基本的な構造変化はなされていない. 病床規制の緩和によって民間病院の新規参入と非効率な病院の淘汰や整理統合によって病院の生産性を高めることが求められる. 第2に, 関西は, 全国, 関東, 中部と比較して医師数と病床数が多いことから, 医療供給としての潜在力の高さが窺える. しかし病院の機能分化は全国と同様に, 関西でも進んでいない. これは日本の医療の生産性が低い要因の1つであり, 関西においても病院と病床の整理・統合, 淘汰は進んでいない. 第3に, 関西は全国と比較して人口あたりの一般病床数が多く, 療養病床数が少ない. 関西では, 病床利用率の観点から, 一般病床の活用の余地があり, 一般病床のより効率的な利用を進め, 医療分野での生産性を高める余地があることがわかった. [Summary] In this paper, I examined the present conditions of the medical productivity in the Kansai area from a standpoint whether the scale and functional differentiation of hospitals have made progress. What this paper found are as follows. First, the Japanese medical supply system has not changed the basic structure from the early 90s to the present. The new entry of private hospitals may be expected by the relaxation of the sickbed regulation. The productivity of hospitals may also be enhanced by the selection and consolidation of inefficient hospitals. Second, in Kansai, the number of medical doctors and hospital beds is greater in comparison with those of national, Kanto and Chubu levels. These indicate that the Kansai area has great potential as medical supplier. However, the functional differentiation of hospitals has not advanced in Kansai just like other areas of the country, either. In this regard, it may be concluded that the Kansai area has not yet made much progress in the field of integration and liquidation of hospitals, which is identified as one of the factors causing low medical productivity in Japan. Third, there is a more general hospital bed capacity per capita in Kansai than the national level, but it is found that there are a fewer hospital beds for medical treatment. Kansai should take some measures to make more effective use of general sickbeds. From the viewpoint of sickbed availability rate, there is room for general sickbeds to be made good use of. Japan has more room to enhance the productivity in the medical field.
[目次] 1. はじめに 2. 医療供給の現状 3. 関西における医療の生産性 3.1. 関西の医療の現状 3.2. 関西の生産性について 4. おわりに

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