{"created":"2025-02-17T10:35:57.461823+00:00","id":2000729,"links":{},"metadata":{"_buckets":{"deposit":"77f301af-7e7e-40be-ae8a-c67c7568d7a2"},"_deposit":{"created_by":41,"id":"2000729","owners":[41],"pid":{"revision_id":0,"type":"depid","value":"2000729"},"status":"published"},"_oai":{"id":"oai:hiroshima.repo.nii.ac.jp:02000729","sets":["1730444918213"]},"author_link":[],"item_1617186331708":{"attribute_name":"Title","attribute_value_mlt":[{"subitem_title":"大腿骨頚部骨折の医療ケア標準化における費用対効果","subitem_title_language":"ja"}]},"item_1617186419668":{"attribute_name":"Creator","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"川渕, 孝一","creatorNameLang":"ja"},{"creatorName":"Kawabuchi, Koichi","creatorNameLang":"en"}],"familyNames":[{"familyName":"川渕","familyNameLang":"ja"},{"familyName":"Kawabuchi","familyNameLang":"en"}],"givenNames":[{"givenName":"孝一","givenNameLang":"ja"},{"givenName":"Koichi","givenNameLang":"en"}]},{"creatorNames":[{"creatorName":"阿部, 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美知子","creatorNameLang":"ja"},{"creatorName":"Moriyama, Michiko","creatorNameLang":"en"}],"familyNames":[{"familyName":"森山","familyNameLang":"ja"},{"familyName":"Moriyama","familyNameLang":"en"}],"givenNames":[{"givenName":"美知子","givenNameLang":"ja"},{"givenName":"Michiko","givenNameLang":"en"}]},{"creatorNames":[{"creatorName":"米村, 憲輔","creatorNameLang":"ja"},{"creatorName":"Yonemura, Kensuke","creatorNameLang":"en"}],"familyNames":[{"familyName":"米村","familyNameLang":"ja"},{"familyName":"Yonemura","familyNameLang":"en"}],"givenNames":[{"givenName":"憲輔","givenNameLang":"ja"},{"givenName":"Kensuke","givenNameLang":"en"}]}]},"item_1617186476635":{"attribute_name":"Access Rights","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_1617186609386":{"attribute_name":"Subject","attribute_value_mlt":[{"subitem_subject":"480","subitem_subject_scheme":"NDC"}]},"item_1617186626617":{"attribute_name":"Description","attribute_value_mlt":[{"subitem_description":"本研究では、急性期病院における在院日数短縮化政策が、大腿骨頸部骨折の治療およびそのアウトカムにどんな影響を及ぼしているかを調査した。まず、4つの急性期病院を対象に、人工骨頭置換術を施行した患者のデータについて、一定の統計分析を行った所、在院日数の他、入院時歩行レベル、痴呆症状、術後感染症、退院先が歩行能力の改善に有意に関連していることが明らかになった。さらに、これに5病院を追加して、調査対象9病院を①自己完結型、②多機能複合型、病病連携型の3つに分けて転院先を含めた費用対効果を求めた所、意外にも自己完結型施設のコスト・パフォーマンスが一番よいことがわかった。他方、治療プロセスが違う三カ国、日本、米国、英国を詳細に比較・検討することによって、大腿骨頚部骨折の費用対効果の差を生み出す要因を明らかにした。また、わが国の大腿骨頚部骨折治療プロセスのモデルを作成し、現在の治療プロセス及びコストの比較を行った。その結果、わが国の一人当たりの入院医療費は米国よりも高いことが分かった。これは治療プロセスにばらつきが大きく、結果的に在院日数を延長し、診療報酬の総点数を押し上げていることによるものである。かりに、わが国の大腿骨頚部骨折全患者をモデルプロセスにあてはやた場合には、240～425億円の医療費の節減効果があることが分かった。","subitem_description_language":"ja"},{"subitem_description":"厚生労働科学研究研究費補助金 政策科学推進研究事業 平成13年度～平成15年度 総合研究報告書","subitem_description_type":"Other"}]},"item_1617186660861":{"attribute_name":"Date","attribute_value_mlt":[{"subitem_date_issued_datetime":"2004-03","subitem_date_issued_type":"Created"}]},"item_1617186702042":{"attribute_name":"Language","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_1617258105262":{"attribute_name":"Resource Type","attribute_value_mlt":[{"resourcetype":"research report","resourceuri":"http://purl.org/coar/resource_type/c_18ws"}]},"item_1617605131499":{"attribute_name":"File","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2023-03-18"}],"displaytype":"simple","filename":"H13-H15_MHLW_FNF.pdf","filesize":[{"value":"296.2 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