| Project/Area Number |
15K19258
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
Medical and hospital managemen
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| Research Institution | Kobe University (2017-2018)
The University of Tokyo (2015-2016) |
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Principal Investigator |
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| Project Period (FY) |
2015-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥2,990,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥690,000)
Fiscal Year 2017: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2016: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2015: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
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| Keywords | 医療政策 / 外来機能分化 / 病院経営 / 外来受診 / 病院機能分化 / 診療コスト / DPC / 原価計算 |
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| Outline of Final Research Achievements |
Among lung cancer patients, we examined the factor of the difference in the cost calculated from fee for service for patients with surgery. As a result, according to the TNM classification, it was found that the cost calculated from fee for service is more expensive that there are lymph node metastasis and invasion to nearby organs, compared with carcinoma in situ and smaller tumors. Also, we compared the profit and loss of the motor neuron disease patients who are mainly treated at university hospitals, and the profit and loss of lung cancer and brain tumor patients who are treated at community hospitals, according to the presence or absence of surgery. It turned out that profitability is low without surgery.
In addition, patients who were not hospitalized one month before and after outpatient visits and who received a medical fee of less than 5,000 yen were frequently found in psychiatry, neurology, orthopedics, neurosurgery, dermatology and anesthesiology.
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| Academic Significance and Societal Importance of the Research Achievements |
一般的にコストがかかると考えられていた手術症例については、診療報酬上でもきちんと手当されており、むしろ手術なし症例での入院のほうが収益性が悪いことが明らかになった。また、前後1ヶ月に入院のない外来患者のうち、1回の診療報酬が5,000円未満の患者が多い診療科も明らかになったことから、特に外科系の診療科の患者のうち、入院に繋がっていない患者や、手術適応ではない患者は大学病院で受診するのではなく、地域の病院で受診してもらうことで、患者にとっても遠くまで通う必要もなく、連携強化により、地域において切れ目のない医療の提供に資することができると考えられる。
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