2024-03-29T10:12:47Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/400982022-11-17T02:08:08Zhdl_2115_35410hdl_2115_35409移動選好指数を用いた受療動向の評価に関する基礎的研究Assessing patient migration by using the migration preference index大場, 久照谷川, 琢海小笠原, 克彦受療動向移動選好指数二次医療圏医療計画patient migrationmigration preference indexsecondary medical care zonehealth plan498目的:本研究では,移動選好指数 (MPI) を用いて入院・外来別の受療動向を分析し,特定地域に対する移動選好度を評価することである。方法:対象地域は北海道の二次医療圏(札幌,上川中部,留萌)とした。分析には平成17年5月診療分国保レセプトデータを用いた。MPI値100を基準として特定地域に対する移動選好度の測定と患者移動圏を画定した。また,流出率による測定との比較評価を行った。結果:札幌の流出圏は外来の1圏域であった。一方,流入圏は入院・外来とも広範囲にわたる10以上の圏域で,近隣圏域だけでなく3次医療圏外(宗谷と留萌)のMPIも高かった。上川中部の流出圏は入院・外来とも北空知へのMPIが高かった。流入圏は入院・外来とも3次医療圏の圏域でMPIが顕著に高かった。MPIと流出率との比較では選好度と流出圏が異なる結果となった。結論:MPIによって患者の特定地域への移動選好度や患者移動圏を定量的に評価できた。Purpose: To analyze migration of in- and out-patients by using the migration preference index (MPI) and evaluate the migration preference patterns of specific areas. Method: Secondary medical care zones (Sapporo, Kamikawa-Chube and Rumoi) in Hokkaido were selected for the areas of the study. Data obtained from the receipts of National Medical Insurance for May 2005 were analyzed. Setting the base MPI at 100, MPIs for specific areas were determined and areas where patients may migrate were projected. The results were compared against those computed from the rates of population outflow. Results: The outflow area for Sapporo was found to be one of the areas where outpatients originate. On the other hand, the inflow area for both in- and out-patients extended to more than 10 areas. Accordingly, MPI was high not only in the neighboring areas but also outside the tertiary medical care zone (Soya and Rumoi). For the outflow area from Kamikawa-Chube, MPI was high in Kita-Sorachi for both in- and out-patients. For the inflow area, MPI was notably high in the tertiary medical care zone for both in- and out-patients. The MPI and outflow rate indicated different preference scale and outflow area. Conclusion: By employing MPI, the patients' migration preferences for specific areas and zones of their actual migration can be quantitatively evaluated.日本医療・病院管理学会Journal Articleapplication/pdfhttp://hdl.handle.net/2115/40098https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/40098/2/ogasawara_JJSHA45_299.pdf1882-594XAA12296781日本医療・病院管理学会誌4542993102008-10jpnpublisher