| Project/Area Number |
18K10098
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
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| Research Institution | Asahikawa Medical College |
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Principal Investigator |
Saijo Yasuaki 旭川医科大学, 医学部, 教授 (70360906)
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| Project Period (FY) |
2018-04-01 – 2022-03-31
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| Project Status |
Completed (Fiscal Year 2021)
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| Budget Amount *help |
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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| Keywords | 地域医療 / 医師確保 / プライマリケア / 地域枠入試 / 地理情報システム（GIS） / 逆紹介 / 医療職の負担 / プライマリケア医 / 地理情報システム（GIS) / 地域枠 / 奨学金 / 地理情報システム(GIS) |
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| Outline of Final Research Achievements |
The unit of observation was secondary medical service areas in Japan. In multivariate models for ischemic heart diseases mortality, primary care facility density was significantly related. In the questionnaire study about original scholarship of town and village municipalities for medical students, town, higher population, and having a hospital were related to allocating physicians. In the multivariate logistic regression for the no counter-referral outcome, hospitalization or scheduled hospitalization in the university hospital, living within 2 h from the university hospital, and visiting two or more specialties had significantly higher odds ratios. After stratification between urban or rural working at present, among urban workers, the entrance exam for regional applicants had a significantly higher OR (3.11); however, among rural workers, it had a significantly lower OR (0.17).
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| Academic Significance and Societal Importance of the Research Achievements |
(1)プライマリケア医へのアクセスの良いことが危険因子管理につながり、虚血性心疾患死亡率を低下させる可能性がある。(2) 地方自治体の独自奨学金による医師確保対策は、村より町、人口が多いこと、病院があることが有意に確保に関連している。 (3)大病院からの逆紹介については、受診初期からの逆紹介を考慮した患者対応と、重症度や複数疾患を考慮し、患者の大病院・専門医と同じレベルの診療への希望へ配所した逆紹介先への適切な連携・調整が重要である。(4)医師確保ために、地域枠入試者と地方勤務の義務がある奨学金は地方勤務の継続につながる可能性がある。
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