Research on the effects of hospital competition and collaboration on hospital management and quality of care in Japan

Research Project

Project/Area Number	17K15743
Research Category	Grant-in-Aid for Young Scientists (B)
Allocation Type	Multi-year Fund
Research Field	Medical sociology
Research Institution	Kyoto University
Principal Investigator	Otsubo Tetsuya 京都大学, 医学研究科, 特定講師 (80551796)
Project Period (FY)	2017-04-01 – 2020-03-31
Project Status	Completed (Fiscal Year 2019)
Budget Amount *help	¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000) Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000) Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000) Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords	医療経済学 / 競争と連携 / 医療の質 / 病院経営 / 評価指標 / DPCデータ
Outline of Final Research Achievements	In this study, I conducted a conceptual organization of market mechanism related to hospital competition and collaboration. Based on this, I revealed the relationship between the situations of competition and collaboration and quality of care and hospital management in Japan. Furthermore, the way of public reporting process was reconsidered through discussions with hospital administrators and clinicians. As a result, some hospitals were responsive to the competitive or collaborative situation. However, the underlying factors that determine these hospital attitudes remain unclear.
Academic Significance and Societal Importance of the Research Achievements	本研究の成果は、今後の医療経済学からのアプローチにより医療における市場の特殊性を検討する際の根拠のひとつとなりうる。諸外国において、医療機関間の競争や連携は医療政策におけるツールとして認知されているが、わが国においてその効果が限定的であることが明らかとなり、社会実装の観点からより効果的な競争や連携のあり方を検討する余地が確認された。競争や連携を推進する手段のひとつとして、診療パフォーマンスの公表が挙げられるが、全院的取組みに昇華されていないといった、社会実装面での課題も明らかとなった。