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ミニ・サム型施設配置モデルを用いた救急医療機関の最適配置の分析 : 北海道の小児急病センターの配置を事例として

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Title: ミニ・サム型施設配置モデルを用いた救急医療機関の最適配置の分析 : 北海道の小児急病センターの配置を事例として
Other Titles: Analysis of the optimum allocation of emergency care institutions by using a model of mini sum facility location : Allocation of pediatric emergency centers in Hokkaido
Authors: 谷川, 琢海1 Browse this author
小笠原, 克彦2 Browse this author →KAKEN DB
大場, 久照3 Browse this author
櫻井, 恒太郎4 Browse this author →KAKEN DB
Authors(alt): Tanikawa, Takumi1
Ogasawara, Katsuhiko2
Ohba, Hisateru3
Sakurai, Tsunetaro4
Keywords: 小児救急医療
pediatric emergency care
operations research
minisum facility location
Issue Date: 1-Jul-2006
Publisher: 日本病院管理学会
Journal Title: 病院管理
Volume: 43
Issue: 3
Start Page: 249
End Page: 260
Abstract: 本研究では患者となる小児人口と移動距離を用いて小児急病センター(施設)の適切な数と配置を明らかにすることを目的としてオペレーションズ・リサーチの手法であるミニ・サム型施設配置モデルを適用して分析を行った。北海道を対象地域とし一次医療圏(212市町村)を単位とした場合に患者の居住地から施設までの総移動距離が最小となるような施設の配置場所と各施設が受け持つ圏域を求めた。本研究では小児救急の視点から以下の3項目について分析を行った;(1) 現在の三次医療圏の中心となる市(6カ所)に施設を配置した場合の妥当性,(2) 現在の二次医療圏の中心となる市町(21カ所)に施設を配置した場合の妥当性,(3) 施設の総数を変化させた場合の数と配置の関係。結果より現在の医療圏の設定に基づいた小児救急医療体制の構築は患者の移動負担の観点から妥当でないことが示唆された。この分析結果は今後の医療計画の見直しのための基礎資料として有用であると考えられる。
In this study, which was designed to elucidate the optimum number and allocation of pediatric emergency centers (facilities) by using the pediatric patient population and the transfer distance, a model of minisum facility location, a procedure in operations research, was analyzed. The allocation of the facilities, at which the total transfer distance from the patient's dwelling place to the facility would become minimum in the primary medical care range (212 municipalities) in Hokkaido, and the range (area) covered by each facility were determined. The following 3 items were analyzed from the viewpoint of pediatric emergency care in this study: (1) The validity of allocation of facilities in the cities (6 places) as the center of the current tertiary medical care facility range; (2) the validity of allocation of facilities in the cities and towns (21 places) as the center of the current secondary medical care range; and (3) relationship between the number of facilities and their allocation when the total number of facilities is variable. The results suggested that construction of a pediatric emergency care system based on establishment of the current medical care range is not valid from the viewpoint of the load of transfer of patients. The results of the analysis are considered to be useful as basic data for reconsideration of medical care plans in the future.
Description: 研究資料
Type: article
Appears in Collections:保健科学院・保健科学研究院 (Graduate School of Health Sciences / Faculty of Health Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 小笠原 克彦

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