Current Status and Issues of Small-Scale Care Units in Medical Institutions for Children with Disabilities

2022 Fiscal Year Final Research Report

• Project/Area Number: 18K04476
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 23030:Architectural planning and city planning-related
• Research Institution: Tsukuba University of Technology
• Principal Investigator: YAMAWAKI HIROKI 筑波技術大学, 産業技術学部, 教授 (60369311)
• Project Period (FY): 2018-04-01 – 2023-03-31
• Keywords: 医療型障害児入所施設 / 小規模グループケア加算 / 加算基準 / 規模要件 / 設備要件

Outline of Final Research Achievements

There are three main physical requirements that contribute to the very low acquisition of small group care premiums for medical institutions for children with disabilities. In particular, it is extremely difficult to achieve the scale requirement of 8 or less capacity by renovation unless it is taken into consideration at the time of planning and construction of the facility. On the other hand, it was found that the equipment requirements and room requirements are more suitable for a small-scale unit type rehabilitation environment than for a hospital model, and that renovations are effective.
On the other hand, staffing requirements and care requirements can be met, but sufficient consideration must be given to shifts, such as allocating early and late work. In addition, during the night time, there were times when the rehabilitation unit was absent due to the care support of another unit located side by side.

Free Research Field

建築計画

Academic Significance and Societal Importance of the Research Achievements

現在、入所型施設の適切な環境づくりとして小規模生活型が目指されているが、医療的なケアを必要とするような重度の障害児入所施設環境に於いては、小規模生活型を目指し達成する事例が極めて少ないのが現状である。本研究では、その指標となる小規模グループケア加算の取得にかかる物理的要件における整備の困難性と、職員配置要件における見守り困難な課題とを明らかにした。今後、医療型障害児入所施設をホスピタルモデルではなく小規模ユニット型の療育環境として形成を目指す際、8名以下という規模要件は十分な見守りを確保する課題に照らして非常に困難な要件であり、制度議論が重要であることを指摘するものである。