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DPC ◊✲⌜䛾௒䜎䛷䛾◊✲ ᮾி་⛉ṑ⛉኱Ꮫ኱Ꮫ㝔 ་⒪ᨻ⟇Ꮫㅮᗙ་⒪ᨻ⟇᝟ሗᏛศ㔝 అぢΎ⚽

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Academic year: 2021

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DPC ◊✲⌜䛾௒䜎䛷䛾◊✲ ᮾி་⛉ṑ⛉኱Ꮫ኱Ꮫ㝔 ་⒪ᨻ⟇Ꮫㅮᗙ་⒪ᨻ⟇᝟ሗᏛศ㔝 అぢΎ⚽

2016

8

29

ᅜ❧኱Ꮫ⑓㝔 ᅜ❧኱Ꮫ⑓㝔 DPC⑓㝔 䝕䞊䝍ᥦ౪ ᝟ሗᥦ౪

୍⯡♫ᅋἲேデ᩿⩌ศ㢮◊✲ᨭ᥼ᶵᵓ䜢௓䛧䛯 ◊✲⌜䜈䛾䝕䞊䝍ᥦ౪䛻䛴䛔䛶 DPC䝕䞊䝍 ᝟ሗᥦ౪ デ᩿⩌ศ㢮 ◊✲ᨭ᥼ᶵᵓ 䝕䞊䝍⟶⌮⩏ົ

DPC◊✲⌜ 䠄అぢ⌜2016䝕䞊䝍⟶⌮⩏ົ 䝕䞊䝍཰㞟䛾ຠ⋡໬ ‡ᖺᗘ䜢㉺䛘䜛㏻ᖺ䛾䝕䞊䝍཰㞟 ‡䝕䞊䝍ᥦ౪⟶⌮䛾୍ඖ໬

་⒪Ᏻ඲◊✲⌜ 䠄అぢ⌜2016Ͳ7䝕䞊䝍⟶⌮⩏ົ ⛉◊㈝◊✲⌜ 䠄అぢ⌜2015Ͳ7䝕䞊䝍⟶⌮⩏ົ⛉◊㈝◊✲⌜ 䠄ᗣỌ⌜2015Ͳ6䝕䞊䝍⟶⌮⩏ົ

ᅜ䛜䜣◊✲⌜ 䠄▼ᕝ⌜2016Ͳ8䝕䞊䝍⟶⌮⩏ົ

་⒪㟂⤥◊✲⌜ 䠄అぢ⌜2016䝕䞊䝍⟶⌮⩏ົ ⛉◊㈝◊✲⌜ 䠄௒୰⌜2016Ͳ8䝕䞊䝍⟶⌮⩏ົ ୍⯡♫ᅋἲேデ᩿⩌ศ㢮◊✲ᨭ᥼ᶵᵓタ❧䛾㊃ព 䠄ⱥᩥྡ⛠䠖DPCResearchInstitute䚸␎⛠䠖DPC◊✲ᨭ᥼ᶵᵓ䠅 ‡ᡃ䛜ᅜ䛷デ᩿⩌ศ㢮DiagnosisProcedureCombination(DPC)䛜㛤Ⓨ䛥䜜䚸ᛴᛶᮇධ 㝔་⒪䛾ໟᣓホ౯䛻⏝䛔䜙䜜䜛䜘䛖䛻䛺䛳䛶䛛䜙8ᖺ௨ୖ䛜⤒㐣䛧䚸DPC䜢⏝䛔䛯 ་⒪⤒Ⴀศᯒ䚸デ⒪䛾㉁䛾ศᯒ䚸ᆅᇦ་⒪ศᯒ➼䛾ᡭἲ䛜㛤Ⓨ䛥䜜䚸DPC་⒪᝟ ሗ䝕䞊䝍䜢ά⏝䛩䜛ྍ⬟ᛶ䛜ᗈ䜎䛳䛶䛔䜛 ‡DPC་⒪᝟ሗ䝕䞊䝍䛾ྲྀ䜚ᢅ䛔䛻䛿䚸ᑓ㛛ⓗ䛺▱㆑䛸ᢏ⾡䛾⵳✚䛜ᚲせ䛷䛒䜚䚸⥅ ⥆ⓗ䛻DPC䝕䞊䝍䛾ྲྀ䜚ᢅ䛔䜢ᨭ᥼䛩䜛⤌⧊䛜ᚲせ ‡デ᩿⩌ศ㢮䛻㛵䛩䜛་⒪᝟ሗ䛾೺඲䛺฼⏝䜢ಁ㐍䛧䚸㛵㐃䛩䜛◊✲➼䛾άື䛻䛴 䛔䛶Ᏻ඲䞉෇⁥䛺ᐇ᪋䜢ᨭ᥼䛩䜛䛣䛸䜢┠ⓗ䛸䛧䛶䚸䛂୍⯡♫ᅋἲேデ᩿⩌ศ㢮◊ ✲ᨭ᥼ᶵᵓ䛃䜢タ❧ ‡ᮏἲே䛿䚸䝕䞊䝍཰㞟䚸ศᯒ⏝䝕䞊䝍䝧䞊䝇సᡂᨭ᥼䚸ศᯒ⏝䝕䞊䝍䝧䞊䝇ᥦ౪䚸 䝕䞊䝍ศᯒ䛻㛵䛩䜛ᨭ᥼䚸䝕䞊䝍ᥦ౪᪋タ䛻ᑐ䛩䜛ᨭ᥼䛺䛹䛾ᴗົ䜢⾜䛔䚸デ᩿ ⩌ศ㢮䛻㛵䛩䜛་⒪᝟ሗ䛾฼⏝䛾ಁ㐍䜢ᅗ䜛 ௦⾲⌮஦ᯇ⏣᫴ဢ ⌮஦అぢΎ⚽ ┘஦すᒸΎ

㻰㼂㻰 䝕䞊䝍

ᖹᡂ䠎䠓ᖺᗘ䛾◊✲ሗ࿌

䕿◊✲⌜䝉䝭䝘䞊䛾㛤ദ 䕿䝕䞊䝍㈨ᩱ䛾㓄௜ ‡䝉䝭䝘䞊➼䛾㓄௜ ㈨ᩱ ‡ཌປ┬බ⾲䝕䞊䝍 ศᯒ䝒䞊䝹 ‡ྛ✀ศᯒ⏝䝬䝇 䝍䞊

᪥᫬ሙᡤෆᐜ 㻞㻜㻝㻡ᖺ㻣᭶㻠᪥㻔ᅵ㻕ᒱ㜧ㅮ₇ 㻞㻜㻝㻡ᖺ㻤᭶㻞㻠᪥䚸㻞㻡᪥໭஑ᕞㅮ₇䞉₇⩦ 㻞㻜㻝㻡ᖺ㻝㻜᭶㻞㻠᪥㻔ᅵ㻕㧗▱ㅮ₇ 㻞㻜㻝㻡ᖺ㻝㻝᭶㻞㻤᪥㻔ᅵ㻕௝ྎㅮ₇ 㻞㻜㻝㻡ᖺ㻝㻞᭶㻡᪥㻔ᅵ㻕ᮾிㅮ₇ 㻞㻜㻝㻢ᖺ㻝᭶㻞㻟᪥㻔ᅵ㻕⚟஭ㅮ₇ 㻞㻜㻝㻢ᖺ㻝᭶㻟㻜᪥㻔ᅵ㻕┒ᒸㅮ₇ 㻞㻜㻝㻢ᖺ㻞᭶㻢᪥㻔ᅵ㻕⚄ᡞㅮ₇ 㻞㻜㻝㻢ᖺ㻟᭶㻡᪥㻔ᅵ㻕ᗈᓥㅮ₇ 㻞㻜㻝㻢ᖺ㻟᭶㻝㻥᪥㻔ᅵ㻕㮵ඣᓥㅮ₇

䛂ᛴᛶᮇ䚸ᅇ᚟ᮇ䜢ྵ䜐་⒪ᶵ⬟䛻ᛂ䛨䛯ᝈ⪅䛾⑓ែホ౯䛸་⒪㈨※㓄ศ䛾䛒 䜚᪉䛻㛵䛩䜛◊✲䛃䠄䠤䠎䠓䠉ᨻ⟇䠉ᣦᐃ䠉䠌䠌䠕䠅 4

163

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ᖹᡂ 28 ᖺᗘ䛾ணᐃ

᪥᫬ሙᡤෆᐜ 㻞㻜㻝㻢ᖺ㻤᭶㻞㻥᪥䚸㻟㻜᪥໭஑ᕞㅮ₇䞉₇⩦ 㻞㻜㻝㻢ᖺ㻝㻜᭶㻝᪥㻔ᅵ㻕ᮾிㅮ₇ 㻞㻜㻝㻢ᖺ㻝㻝᭶㻡᪥㻔ᅵ㻕┒ᒸㅮ₇ 㻞㻜㻝㻢ᖺ㻝㻞᭶㻟᪥㻔ᅵ㻕᪂₲ㅮ₇ 㻞㻜㻝㻢ᖺ㻝㻞᭶㻝㻜᪥㻔ᅵ㻕⚟஭ㅮ₇ 㻞㻜㻝㻣ᖺ㻝᭶㻞㻝᪥㻔ᅵ㻕಴ᩜㅮ₇ 㻞㻜㻝㻣ᖺ㻞᭶㻠᪥㻔ᅵ㻕⚄ᡞㅮ₇ 㻞㻜㻝㻣ᖺ㻟᭶㻠᪥㻔ᅵ㻕⇃ᮏㅮ₇ 㻞㻜㻝㻣ᖺ㻟᭶㻝㻝᪥㻔ᅵ㻕ᒣཱྀㅮ₇

䕿◊✲⌜䝉䝭䝘䞊䛾㛤ദ 䕿䝕䞊䝍㈨ᩱ䛾㓄௜

‡

䝬䝇䝍䞊㢮➼

ᖹᡂ

28

ᖺᗘ

DPC

ኟᏘ䝉䝭䝘䞊䝥䝻䜾䝷䝮

829᪥䠄᭶䠅኱䝩䞊䝹ㅮᖌᑠ䝩䞊䝹 11:15Ͳ12:15௒䜎䛷䛾◊✲⌜䛾ᡂᯝఅぢ11:15Ͳ12:15ExcelDPC䝕䞊䝍ศᯒ䐟 ᫨㣗 13:30Ͳ14:30䝁䞊䝕䜱䞁䜾䛸⑓㝔ᣦᶆ⸨᳃13:30Ͳ14:30BI䝒䞊䝹Tableauධ㛛 14:45Ͳ15:45ᆅᇦ་⒪ศᯒ▼ᕝ14:45Ͳ15:45ᵝᘧ1₇⩦ 16:00Ͳ17:00䝁䞊䝕䜱䞁䜾㜿༡16:00Ͳ17:00DPC䝕䞊䝍ศᯒึ⣭䞉 ⑓㝔ᣦᶆసᡂ 830᪥䠄ⅆ䠅኱䝩䞊䝹ㅮᖌᑠ䝩䞊䝹 10:00Ͳ11:00⮫ᗋ␿Ꮫ◊✲ᗣỌ10:00Ͳ11:00ExcelDPC䝕䞊䝍ศᯒ䐠 11:15Ͳ12:15་⒪䛾㉁ᅧ⃝11:15Ͳ12:15BI䝒䞊䝹Tableauධ㛛 ᫨㣗 13:30Ͳ14:30DPC䛸་⒪䝬䝛䝆䝯䞁䝖ᯇ⏣13:30Ͳ14:30Qliksenceධ㛛 䠄ሙᡤ䠖⚟ᒸ┴໭஑ᕞᕷ⏘ᴗ་⛉኱Ꮫ䠅

ᖹᡂ 27 ᖺᗘ⥲ᣓ◊✲ሗ࿌᭩ูῧ䠠䠲䠠཰㍕ෆᐜ

䠍䠊ᮏሗ࿌᭩䠬䠠䠢∧䠄ⓑ㯮䚸䝣䝹䜹䝷䞊䠅 䠎䠊◊✲ሗ࿌᭩㏣ຍ㈨ᩱ䐟ศᢸ◊✲ሗ࿌᭩䠄௒୰㞝୍䠅䛂デ᩿⩌ศ㢮䜢ά⏝ 䛧䛯་⒪䛾㉁䛸་⒪㈨※䛾ホ౯䛃 ௒୰㞝୍䚸ᅧ⃝㐍䚸బ䚻ᮌ඾Ꮚ䚸⊦㣫ᏹ 䐠ศᢸ◊✲ሗ࿌᭩(▼ᕝග୍)䛂་⒪㈨※ᢞධ㔞䛾 ⤒᪥ⓗ䛺㞟ィ䛻ᇶ䛵䛟⑓ᗋᶵ⬟䛾ศᯒ䛃ཧ⪃㈨ᩱ ▼ᕝ䝧䞁䝆䝱䝭䞁ග୍ 䠏䠊DPC◊✲⌜䛂DPCไᗘ䛾㐺ṇ㐠⏝䛸DPC䝕䞊䝍ά⏝ಁ㐍䛾䛯䜑䛾䝉䝭䝘䞊䛃㓄௜㈨ᩱ 䠐䠊◊✲⌜సᡂ䠠䠬䠟䝕䞊䝍ศᯒ⏝ 䝬䝇䝍䞊䝣䜯䜲䝹୍ᘧ䐟ᖹᡂ䠎䠓ᖺᗘ䝺䝉䝥䝖㟁⟬䝁䞊䝗䝬䝇䝍䞊 䐠ᖹᡂ䠎䠓ᖺᗘᡭ⾡䠧䝁䞊䝗䝬䝇䝍䞊 䐡ᖹᡂ䠎䠓ᖺᗘ໬Ꮫ⒪ἲ䝬䝇䝍䞊 䐢ᖹᡂ䠎䠓ᖺᗘ⾑ᾮ〇๣䝬䝇䝍䞊 䠑䠊◊✲⌜సᡂ䝥䝻䜾䝷䝮䛸䝕䞊䝍䐟ᖹᡂ26ᖺᗘཌປ┬බ⾲䝕䞊䝍DPC⑓㝔䝕䞊䝍䝧䞊 䝇 7

ᖹᡂ 26 ᖺᗘ◊✲ሗ࿌᭩ ௜㘓ཧ⪃㈨ᩱ㞟䛾౑䛔᪉䠄䠍䠅 ‡ DPC デ ᩿ ⩌ ศ 㢮 䛸 ໟ ᣓ ホ ౯ ไ ᗘ 䜢 䜘 䜚 ῝ 䛟 ⌮ ゎ 䛧 䛯 䛔 ᪉

±

◊✲⌜䝉䝭䝘䞊䛾

PDF

㈨ᩱ䜢ぢ䛶䛔䛯䛰䛡䜜䜀䚸

DPC

デ᩿⩌ศ㢮䛾ᴫせ䚸⌧ᅾ䛾ㄢ㢟䛺䛹䛜⌮ゎ 䛷䛝䜎䛩䚹

±

௜㘓

DVDͲROM

ෆ䛻䝉䝭䝘䞊䛷䛾㓄௜㈨ᩱ

±8

21

᪥䞉

22

᪥䛾⏘ᴗ་኱኱䝩䞊䝹䛷䛾䝉䝭䝘䞊 䛾ෆᐜ䛜⥙⨶ⓗ

164

(3)

ᖹᡂ 25 ᖺᗘ◊✲ሗ࿌᭩ ௜㘓ཧ⪃㈨ᩱ㞟䛾౑䛔᪉䠄䠎䠅

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㝔 ෆ 䛺 䛹 䛾

DPC

䝕 䞊 䝍 䜢 ౑ 䛳 䛯 ศ ᯒ 䜢 䛧 䛶 䜏 䛯 䛔 ᪉

±

◊✲ሗ࿌᭩䛸䝉䝭䝘䞊㈨ᩱ䛛䜙䚸

DPC

䝕䞊䝍䛻ྵ䜎䜜䛶䛔䜛 䝕䞊䝍䛸䛭䛾ศᯒ౛䜢Ꮫ䜣䛷䛟䛰䛥䛔䚹

‡821᪥䞉22᪥䛾⏘ᴗ་኱ᑠ䝩䞊䝹₇⩦ ‡ศᯒ䛻ᚲせ䛺䝬䝇䝍䞊䝕䞊䝍䜒ά⏝䛷䛝䜎䛩䚹 ±䝺䝉䝥䝖㟁⟬䝁䞊䝗䚸ᡭ⾡K䝁䞊䝗䚸໬Ꮫ⒪ἲ䚸⾑ᾮ〇๣䛺䛹 ‡

බ 㛤 ⏝ 䛾 ⑓ 㝔 ᣦ ᶆ 䜢 స 䜛 䛯 䜑 䛾 ศ ᯒ 䜢 ⾜ 䛳 䛶 䜏 䛯 䛔 ᪉

±

⮬㝔䛾䝕䞊䝍䜢㞟ィ䚸ศᯒ䛧䛶䚸ᇶᮏⓗ䛺ᣦᶆ䜢බ⾲

‡821᪥䞉22᪥䛾⏘ᴗ་኱ ‡ᖹᡂ26ᖺᗘሗ࿌᭩p179Ͳ

ᖹᡂ 26 ᖺᗘ◊✲ሗ࿌᭩ ௜㘓ཧ⪃㈨ᩱ㞟䛾౑䛔᪉䠄䠏䠅

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ཌ ⏕ ປ ാ ┬ 䛾

DPC

⑓ 㝔 බ ⾲ 䝕 䞊 䝍 䜢 ౑ 䛳 䛶 䚸 ᆅ ᇦ ་ ⒪ ศ ᯒ 䜢 䛧 䛶 䜏 䛯 䛔 ᪉

±

බ⾲䛥䜜䛶䛔䜛䝕䞊䝍䜢ຍᕤ䛧䛶䚸䝕䞊䝍䝧䞊䝇໬䛧䚸䜶 䜽䝉䝹䛾䝢䝪䝑䝖䝔䞊䝤䝹䛷⡆༢䛻ᆅᇦ䛾་⒪ᶵ㛵䛾ᝈ ⪅ᩘ䛺䛹䜢㞟ィ䚸ྍど໬䛩䜛䝒䞊䝹䜢సᡂ䛧䚸㓄ᕸ䛧䛶䛔 䜎䛩䚹

±

㒔㐨ᗓ┴䞉஧ḟ་⒪ᅪู䛻⑓㝔ู䚸യ⑓ู䚸ᡭ⾡᭷↓ู 䛺䛹䛾㞟ィ䚸䜾䝷䝣໬

‡821᪥䞉22᪥䛾⏘ᴗ་኱䛺䛹 ‡ᖹᡂ26ᖺᗘሗ࿌᭩p305Ͳ ±

䜘䜚ヲ⣽䛻ศᯒ䛧䛯䛔ሙྜ䛿䚸

Qlikview

䜢䚹

‡821᪥䞉22᪥䛾⏘ᴗ་኱䛺䛹 ‡ᖹᡂ26ᖺᗘሗ࿌᭩p385Ͳ

ᖹᡂ 26 ᖺᗘ◊✲ሗ࿌᭩ ௜㘓ཧ⪃㈨ᩱ㞟䛾౑䛔᪉䠄䠐䠅

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㧗 ᗘ 䛺 ᆅ ⌮ ᝟ ሗ

GIS

ศ ᯒ 䜢 ⾜ 䛳 䛶 䜏 䛯 䛔 ᪉

±

ᆅᇦ䛻䛚䛡䜛⮬㝔䛾ᙺ๭䜢ㄆ㆑䛩䜛䛣䛸䛿䜎䛩䜎䛩㔜せ

±

↓ൾ䛾

GIS

ᆅ⌮᝟ሗศᯒ䝅䝇䝔䝮䝋䝣䝖䜢ά⏝䛩䜛䛯䜑䛾 䝉䝭䝘䞊

‡821᪥䞉22᪥䛾⏘ᴗ་኱ ‡ᖹᡂ26ᖺᗘሗ࿌᭩p385Ͳ

ᖹᡂ 28 ᖺᗘ௨㝆䛾 DPC 㛵㐃◊✲䛾᪉ྥᛶ

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デ᩿⩌ศ㢮䜢⏝䛔䛯እ᮶ᶵ⬟䚸䜰䜴䝖䝷䜲䝲䞊ホ౯ 䜢ྵ䜐⑓㝔ᶵ⬟ホ౯ᡭἲ䛸䝉䜻䝳䜰䛺䝕䞊䝍䝧䞊䝇 ฼ά⏝ᡭἲ䛾㛤Ⓨ䛻㛵䛩䜛◊✲䠄

H28Ͳ

ᨻ⟇

Ͳ

ᣦᐃ

Ͳ 009

䠅 䐟 ་⒪㈨※ᚲせ㔞䜢㐺ṇ䛻཯ᫎ䛩䜛䜰䜴䝖䝷䜲 䝲䞊䜢⪃៖䛧䛯デ᩿⩌ศ㢮䛾⢭⦓໬ 䐠

DPC

䝕䞊䝍䛾䝉䜻䝳䜰䛺฼ά⏝ᡭἲ䛾㛤Ⓨ

165

(4)

H28DPC ᨵゞ䛾ᴫせ

‡ϩ

⩌䛾ᐇ⦼せ௳䛻≉ᐃෆ⛉デ⒪䜢㏣ຍ

‡

ᇶ♏ಀᩘ㓄ศ䛿ኚ᭦䛺䛧

‡

ᶵ⬟ホ౯ಀᩘ

ϩ

䛿ศᩓ䛷⿵ṇ

‡Ϩ

⩌䚸

ϩ

⩌䛾ῶ⟬䠄ศ㝔䚸⢭⚄⑓ᗋ➼䜢ホ౯䠅

‡

⑓㝔᝟ሗ䛾බ⾲䠄ᖹᡂ䠎䠕ᖺᗘ䜘䜚䠅

‡

䜹䝞䞊⋡ୗ㝈䜢䠏䠌䠂䛻

‡

㔜⑕ᗘಀᩘ䛾ᑟධ

‡

ᚋⓎရ་⸆ရಀᩘ䠓䠌䠂䜎䛷ホ౯

‡

Ϫ

᪥䜢ᅛᐃ໬䠄䠏䠌᪥䚸䠒䠌᪥䚸➼䠅

‡

ධ㝔᪥ᩘ

Ϫ

䛾Ⅼᩘ䜢㐺ṇ໬

ㄪᩚಀᩘ

ᶵ⬟ホ౯ಀ ᩘ䛾ᙉ໬ 㻰㻼㻯ศ㢮䛾 ⢭⦓໬

⦰ᑠᙜึ䛾ᮇᚅ 䛸䛣䜝䛜䚸㻰㻼㻯ཧຍ⑓㝔䛾ᛴ⃭䛺ከᵝ໬䜒䛒䛳䛶䚸ㄪᩚಀᩘ䛿 ㄪᩚಀᩘ䛜⑓㝔䛾᪤ᚓᶒ┈໬

ㄪᩚಀᩘ䛻䛚䛡䜛ㄗ⟬

166

(5)

ᶵ⬟ホ౯ಀᩘ䛸㔜⑕ᗘಀᩘ䠄 Ϫ ⩌䠅 ᶵ⬟ホ౯ಀᩘ䛸㔜⑕ᗘಀᩘ䠄 Ϩ ⩌䠅 ᶵ⬟ホ౯ಀᩘ䛸㔜⑕ᗘಀᩘ䠄 ϩ ⩌䠅

167

(6)

A୍⯡ⓗ䛺デ᩿⩌ศ㢮Bධ㝔ึᮇ䛾་⒪㈨※ᢞධ㔞䛾ከ䛔デ᩿⩌ศ㢮 Cධ㝔ึᮇ䛾་⒪㈨※ᢞධ㔞䛾ᑡ䛺䛔デ᩿⩌ศ㢮D㧗㢠⸆๣➼䛻ಀ䜛デ᩿⩌ศ㢮 Ϩධ㝔䛒䛯䜚ᨭᡶ䛔䛻㏆䛔᪉ᘧ䠅

㻰㻼㻯Ⅼᩘ⾲䛾Ⅼᩘタᐃ᪉ἲ䠄䠐✀䠅 DPC ◊✲⌜䝕䞊䝍཰㞟䞉ศᯒ䝅䝇䝔䝮

168

(7)

㔜⑕ᗘ䜢⪃៖䛧䛯ホ౯ᡭἲ 䠄 CCP Ma trix 䠅䛻䛴䛔䛶

‡ ᖹ ᡂ 30 ᖺ ᗘ 䛾 ㄪ ᩚ ಀ ᩘ ᗫ Ṇ 䛻 ྥ 䛡 䚸 䜘 䜚 ṇ ☜ 䛻 ་ ⒪ ㈨ ※ ᚲ せ 㔞 䜢 デ ⒪ ሗ 㓘 ᨭ ᡶ 䛔 䛻 ཯ ᫎ 䛥 䛫 䜛 䛣 䛸 䛜 ᚲ せ 䚹 ‡ ౛ 䛘 䜀 䚸 ⑓ 㝔 ẖ 䛾 ⫵ ⅖ ᝈ ⪅ 䛾 ⑓ ែ 䞉 㔜 ⑕ ᗘ 䛾 㐪 䛔 䜢 DPC ศ 㢮 䛷 䛿 ༑ ศ 㐺 ษ 䛻 ホ ౯ 䛥 䜜 䛶 䛔 䛺 䛔 ྍ ⬟ ᛶ 䚹 ‡ DPC ศ 㢮 䛾 ᭦ 䛺 䜛 ⢭ ⦓ ໬ 䛜 ᚲ せ 䛰 䛜 䚸 ศ 㢮 ᩘ 䛿 ቑ 䜔 䛫 䛺 䛔 䚹 ‡ 䛂 㔜 ⑕ ᗘ 䜢 ⪃ ៖ 䛧 䛯 ホ ౯ ᡭ ἲ 䛃 CCP(Comorbidity Complic at ion Pr ocedur e) 䝬 䝖 䝸 䝑 䜽 䝇 䛾 タ ィ ᡭ ἲ 䜢 ᳨ ウ

㔜⑕ᗘ䜢⪃៖䛧䛯ホ౯ᡭἲ (CCP 䝬䝖䝸䝑䜽䝇 ) ᶞᙧᅗ䛷⾲䛥䜜䛯⌧⾜䛾 DPC ศ㢮䛾ㄢ㢟 ‡ ศᒱ᮲௳䛜ᯞ䜟䛛䜜䛾䛹䛾㝵ᒙ䚸఩⨨䛻䛒䜛 䛛䛷ศ㢮䛾సᡂ᪉ἲ䛜ไ㝈 ‡ ᨭᡶศ㢮ᩘ䛾ไ㝈䛛䜙᮲௳タᐃ䛜ぢ㏦䜙䜜䜛

⌧⾜ศ㢮 1 യ⑓ྡ

ᡭ⾡ ᡭ⾡䞉ฎ⨨1 ᡭ⾡䞉ฎ⨨2 ๪യ⑓ 2 3 4 5 2241

CCP 䝬䝖䝸䝑䜽䝇䛾⪃䛘᪉䠄䠍䠅 ‡ ᡭ⾡ฎ⨨䛸๪യ⑓➼䛾⤌䜏ྜ䜟䛫䛻ᇶ䛵䛟་ ⒪㈨※ᚲせᗘศ㢮䛷䛒䜛䚹 ‡ ᯞศ䛛䜜䛾ᵓ㐀䛻䛸䜙䜟䜜䛪䛻་⒪㈨※ᚲせ ᗘ䛜㢮ఝ䛧䛯䜾䝹䞊䝥䜢䜎䛸䜑䜛䛣䛸䛜䛷䛝䜛䚹

๪യ⑓➼ 䛺䛧⢾ᒀ⑓ᩋ⾑⑕ ᡭ⾡䞉ฎ⨨➼㻞

䛺䛧పప୰ ୰ᚰ㟼⬦ᰤ㣴୰୰㧗 ໬Ꮫ⒪ἲ୰㧗㧗 䞉䛣䛾౛䛷䛿䠕༊ศ䜢㻟ẁ㝵䛻ᅽ⦰䛧䛶ศ㢮ᩘ䜢ῶ䜙䛩䛣䛸䛜ྍ⬟ 䞉䛣䛾䜘䛖䛺㻞ḟඖ䛾⤌䜏ྜ䜟䛫䛻㝈䜙䛪䚸ከḟඖ䛷㞟⣙䛜ྍ⬟䛸䛺䜛

169

(8)

CCP 䝬䝖䝸䝑䜽䝇ศ㢮䛾⪃䛘᪉䠄䠎䠅

‡CCP

䝬䝖䝸䝑䜽䝇䛿䚸ศᒱ᮲௳䛻ᇶ䛵䛔䛶඲䛶䛾ศ㢮䜢ᶞ ᙧᅗ䛻᭩䛝ୗ䛧䛯ᶞᙧᅗศ㢮䛸䚸་⒪㈨※ᚲせᗘ䛻ᛂ䛨 䛯ᨭᡶศ㢮䛸䛾ᑐᛂ⾲䜢సᡂ䛩䜛䛣䛸䛸ྠ䛨ព࿡䛷䛒䜛䚹

യ⑓ྡ

ᶞᙧᅗศ㢮CCP䝬䝖䝸䝑䜽䝇ᨭᡶศ㢮 䠄་⒪㈨※ᚲせᗘ䠅 ศ㢮p01䠄ప䠅 ศ㢮p02䠄୰䠅

2 ศ㢮p03䠄㧗䠅

ศ㢮01 ศ㢮02 ศ㢮03 ศ㢮04 ศ㢮05 ศ㢮06 ศ㢮07 ศ㢮08 ศ㢮09

ศ㢮p01䠄ప䠅 ศ㢮p02䠄୰䠅 ศ㢮p02䠄୰䠅 ศ㢮p02䠄୰䠅 ศ㢮p03䠄㧗䠅

ศ㢮p03䠄㧗䠅

㒊ศⓗヨ⾜䛻䛴䛔䛶 ‡ CCP 䝬䝖䝸䝑䜽䝇䛾᭷⏝ᛶ䜢☜ㄆ䛩䜛䛯䜑䛻䚸 ẚ㍑ⓗ䛻⑕౛ᩘ䛜ከ䛟䚸⌧⾜䛾ศ㢮䛷䛿ㄢ 㢟䛾䛒䜛㒊ศ䜢ඛ⾜ⓗ䛻᳨ウ䛩䜛䛾䛿䛹䛖 䛛䚹 ‡ ◊✲⌜䛷᳨ウ䛧䛯⫵⅖䚸⢾ᒀ⑓䚸ᚰ୙඲䚸⬻ ⾑⟶㞀ᐖ䚸៏ᛶ㛵⠇䝸䜴䝬䝏䚸ඛኳᛶᚰ⑌ᝈ 䛺䛹䜢᳨ウ䛩䜛䛾䛿䛹䛖䛛䚹 CCP 䝬䝖䝸䝑䜽䝇䛾ᑟධ ‡ DPC Ⅼᩘ⾲䛾ぢ䛛䛡ୖ䛿䚸ศ㢮ᩘ䛜኱ᖜ䛻 ቑຍ

±CCP

䝬䝖䝸䝑䜽䝇䛻㐺䛧䛯⾲♧᪉ἲ䛜ᑟධ䛥䜜䛺 䛛䛳䛯䛯䜑

±

ከ䛟䛾ศ㢮䛷᪥ᩘ䛸Ⅼᩘ䛜඲䛟ྠ୍䛻䛺䛳䛶䛔䜛 ‡ CCP 䝬䝖䝸䝑䜽䝇䛻㐺䛧䛯⾲⌧᪉ἲ䜢᳨ウ䛩䜛 ᚲせ

⬻᱾ሰ䞉ᡭ⾡䛺䛧䛾 CCP 䝬䝖䝸䝑䜽䝇

Ⓨ⑕㻟᪥┠௨ෆ 䛛䛴 㻶㻯㻿㻝㻜ᮍ‶

Ⓨ⑕㻟᪥┠௨ෆ 䛛䛴 㻶㻯㻿㻝㻜௨ୖ

Ⓨ⑕㻠᪥┠௨㝆 ཪ䛿↓⑕ೃᛶ 䛛䛴 㻶㻯㻿㻝㻜ᮍ‶

Ⓨ⑕㻠᪥┠௨ ཪ䛿↓⑕ೃ 䛛䛴 㻶㻯㻿㻝㻜௨ୖ ᡭ⾡䞉 ฎ⨨➼ 䠎

๪യ⑓ 䛺䛧䞉 ๪യ⑓䠍 䛒䜚

๪യ⑓䠎 䛒䜚

๪യ⑓ 䛺䛧䞉 ๪യ⑓䠍 䛒䜚

๪യ⑓䠎 䛒䜚

๪യ⑓ 䛺䛧䞉 ๪യ⑓䠍 䛒䜚

๪യ⑓䠎 䛒䜚

๪യ⑓ 䛺䛧䞉 ๪യ⑓䠍 䛒䜚

๪യ 䛒 䛺䛧 㻜㻝㻜㻟㻜㻝㻜㻟㻜㻝㻜㻟㻜㻝 䠍䛒䜚 䠎䛒䜚㻜㻟㻜㻡㻜㻟㻜㻡㻜㻟㻜㻡㻜㻟 䠏䛒䜚 㻜㻞㻜㻣 㻜㻞㻜㻣 㻜㻞㻜㻣 㻜㻞 䠐䛒䜚㻜㻢㻜㻢㻜㻢 䠑䛒䜚㻜㻠㻜㻣㻜㻠㻜㻣㻜㻠㻜㻣㻜㻠

170

(9)

⬻᱾ሰ䞉⤒⓶ⓗ⬻⾑⟶ᙧᡂ⾡➼䛾 CCP 䝬䝖䝸䝑䜽䝇

Ⓨ⑕㻟᪥┠௨ෆ 䛛䛴 㻶㻯㻿㻝㻜ᮍ‶

Ⓨ⑕㻟᪥┠௨ෆ 䛛䛴 㻶㻯㻿㻝㻜௨ୖ

Ⓨ⑕㻠᪥┠௨㝆 ཪ䛿↓⑕ೃᛶ 䛛䛴 㻶㻯㻿㻝㻜ᮍ‶

Ⓨ⑕㻠᪥┠௨㝆 ཪ䛿↓⑕ೃᛶ 䛛䛴 㻶㻯㻿㻝㻜௨ୖ ᡭ⾡䞉 ฎ⨨➼ 䠎

๪യ⑓ 䛺䛧䞉 ๪യ⑓䠍 䛒䜚

๪യ⑓䠎 䛒䜚

๪യ⑓ 䛺䛧䞉 ๪യ⑓䠍 䛒䜚

๪യ⑓䠎 䛒䜚

๪യ⑓ 䛺䛧䞉 ๪യ⑓䠍 䛒䜚

๪യ⑓䠎 䛒䜚

๪യ⑓ 䛺䛧䞉 ๪യ⑓䠍 䛒䜚

๪യ⑓䠎 䛒䜚 䛺䛧 㻜㻝 䠍䛒䜚 䠎䛒䜚 㻜㻣㻜㻞 䠏䛒䜚 䠐䛒䜚㻜㻞 㻜㻣㻜㻞 㻜㻣㻜㻞 㻜㻣㻜㻞 㻜㻣 䠑䛒䜚㻜㻠㻜㻠㻜㻠㻜㻠

⬻᱾ሰ䞉ື⬦ᙧᡂ⾡䚸࿀ྜ⾡ 㢌⵹ෆື⬦➼䛾 CCP 䝬䝖䝸䝑䜽䝇

ᡭ⾡䞉ฎ⨨➼䠎Ⓨ⑕㻟᪥┠௨ෆⓎ⑕㻠᪥┠௨㝆 ཪ䛿↓⑕ೃᛶ 䛺䛧 㻜㻟 䠍䛒䜚 䠎䛒䜚 㻜㻣㻜㻞 䠏䛒䜚 䠐䛒䜚 㻜㻣 䠑䛒䜚

⬻᱾ሰ䞉䛭䛾௚䛾ᡭ⾡䛾 CCP 䝬䝖䝸䝑䜽䝇

Ⓨ⑕㻟᪥┠௨ෆⓎ⑕㻠᪥┠௨㝆 ཪ䛿↓⑕ೃᛶ ᡭ⾡䞉ฎ⨨ ➼䠍ᡭ⾡䞉ฎ⨨ ➼䠎

๪യ⑓ 䛺䛧䞉 ๪യ⑓䠍 䛒䜚

๪യ⑓䠎 䛒䜚

๪യ⑓ 䛺䛧䞉 ๪യ⑓䠍 䛒䜚

๪യ⑓䠎 䛒䜚 䛺䛧

䛺䛧 㻜㻡 㻜㻣

㻜㻟㻜㻡 䠍䛒䜚 䠎䛒䜚 㻜㻣䠏䛒䜚 㻜㻢㻜㻢 䠐䛒䜚 䠑䛒䜚㻜㻣㻜㻣 䛒䜚

䛺䛧 㻜㻡㻜㻣 㻜㻟㻜㻡 䠍䛒䜚 䠎䛒䜚 㻜㻣

㻜㻣 䠏䛒䜚 㻜㻣䠐䛒䜚 䠑䛒䜚

CCP 䝬䝖䝸䝑䜽䝇ヨ⾜౛䡬⫵⅖ 㔜⑕ᗘ ᖹᆒᅾ㝔᪥ᩘ

1

᪥䛒䛯䜚ໟᣓ⠊ᅖⅬᩘ ㍍⑕

11.3

10.12681

487

୰➼⑕

18.0

16.42582

561

㔜⑕

22.8

20.72648

654

㉸㔜⑕

24.9

24.42881

958

䠍䠊ᐃ⩏⾲䛾ᩚഛ䛸䠎䠊ศᒱ᮲௳䛾ᩚ⌮

±

㔜⑕ᗘ䛜་⒪㈨※ᚲせ㔞䛻ᙳ㡪䛧䛶䛔䜛䛣䛸䛜 ᫂䜙䛛䛸䛺䛳䛯䚹

䠄ᅜ㝿་⒪⚟♴኱ụ⏣䠅36

171

(10)

0

5001000

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ேᕤ࿧྾ჾ䛺䛧

ேᕤ࿧྾ჾ䛺䛧

ேᕤ࿧྾ჾ䛺䛧

ேᕤ࿧྾ჾ䛺䛧

ேᕤ࿧྾ჾ䛺䛧

ேᕤ࿧྾ჾ䛺䛧

ேᕤ࿧྾ჾ䛺䛧

ேᕤ࿧྾ჾ䛺䛧

ேᕤ࿧྾ჾ䛒䜚

ேᕤ࿧྾ჾ䛒䜚

ேᕤ࿧྾ჾ䛒䜚

ேᕤ࿧྾ჾ䛒䜚

ேᕤ࿧྾ჾ䛒䜚

ேᕤ࿧྾ჾ䛒䜚

ேᕤ࿧྾ჾ䛒䜚

ேᕤ࿧྾ჾ䛒䜚

๪യ⑓ 䛺䛧๪യ⑓ 䛺䛧๪യ⑓ 䛒䜚๪യ⑓ 䛒䜚๪യ⑓ 䛺䛧๪യ⑓ 䛒䜚๪യ⑓ 䛒䜚๪യ⑓ 䛺䛧๪യ⑓ 䛺䛧๪യ⑓ 䛒䜚๪യ⑓ 䛺䛧๪യ⑓ 䛒䜚๪യ⑓ 䛒䜚๪യ⑓ 䛺䛧๪യ⑓ 䛺䛧๪യ⑓ 䛒䜚 ㍍⑕୰➼⑕୰➼⑕㍍⑕㔜⑕㔜⑕㉸㔜⑕㉸㔜⑕㍍⑕୰➼⑕୰➼⑕㍍⑕㔜⑕㔜⑕㉸㔜⑕㉸㔜⑕

⫵⅖䛾 1 ᪥ᙜ䛯䜚ໟᣓⅬᩘᖹᆒ್ 䠄㝖እ䠖ᅾ㝔᪥ᩘ

21

᪥௨ୖ䚸Ṛஸ㏥㝔䠅

䠄ᅜ㝿་⒪⚟♴኱ụ⏣䠅‡ேᕤ࿧྾ჾ䛾౑⏝䛜1᪥䛒䛯䜚ໟᣓ⠊ᅖ Ⅼᩘ䛻ᙳ㡪䛧䛶䛔䜛䛣䛸䛜᫂䜙䛛䛸䛺䛳䛯䚹

ᕷ୰⫵⅖䠄ᡂே䠅䛾 CCP 䝬䝖䝸䝑䜽䝇

㻢㻡ᮍ‶ 㻣㻡ᮍ‶ ௨ୖ

㻢㻡ᮍ‶ 㻣㻡ᮍ‶ ௨ୖ

௨ୖ㻡ṓ ௨ୖ㻡ṓ ௨ୖ

௨ୖṓᮍ ௨ୖṓᮍ ௨ୖ

䛭䛾௚䛾⫵⅖䛾 CCP 䝬䝖䝸䝑䜽䝇

ᑠඣ ᡭ⾡䛺䛧ᡭ⾡䞉ฎ⨨➼䠎䛺䛧㻜㻝 ᡭ⾡䞉ฎ⨨➼䠎䛒䜚㻜㻟 ᡭ⾡䛒䜚ᡭ⾡䞉ฎ⨨➼䠎䛺䛧㻜㻝 ᡭ⾡䞉ฎ⨨➼䠎䛒䜚㻝㻞 ᕷ୰⫵⅖௨እ䠄ᡂே䠅 ᡭ⾡䛺䛧ᡭ⾡䞉ฎ⨨➼䠎䛺䛧㻜㻣 ᡭ⾡䞉ฎ⨨➼䠎䛒䜚㻝㻜 ᡭ⾡䛒䜚ᡭ⾡䞉ฎ⨨➼䠎䛺䛧㻝㻟 ᡭ⾡䞉ฎ⨨➼䠎䛒䜚㻝㻡

CCP 䝬䝖䝸䝑䜽䝇ヨ⾜౛䡬⢾ᒀ⑓ 䠍䠊ᐃ⩏⾲䛾ᩚഛ䛸䠎䠊ศᒱ᮲௳䛾ᩚ⌮

±

ከኚ㔞ゎᯒ➼䛻䜘䜚䚸௨ୗ䛾㡯┠䛜་⒪㈨※ᾘ ㈝䛻ᙳ㡪䛧䛶䛔䜛䛣䛸䛜᫂䜙䛛䛸䛺䛳䛯䚹

㡯┠ෆᐜ യ⑓ྡ་⒪㈨※⑓ྡ䛾ᮎᲈᚠ⎔ྜే⑕䛸ከⓎྜే⑕ 䠄㻵㻯㻰㻝㻜䝁䞊䝗㻠᱆┠䛜㻡䜎䛯䛿㻣䠅 ᡭ⾡ᡭ⾡䛾᭷↓ ᡭ⾡䞉ฎ⨨➼䠍 ᡭ⾡䞉ฎ⨨➼䠎䜲䞁䝇䝸䞁౑⏝䛾᭷↓ ྜే⑕≉ᐃ䛾ྜే⑕䛾᭷↓ 䠄ㄆ▱⑕䚸㛢ሰᛶື⬦⑌ᝈ䚸⫶䛾ᝏᛶ⭘⒆䚸⫢◳ኚ䚸⭸㛵⠇⑕ ៏ᛶ⭈୙඲䠅 㔜⑕ᗘᖺ㱋ṓ௨ୖ

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41

⢾ᒀ⑓䛾 CCP 䝬䝖䝸䝑䜽䝇

ᡭ⾡യ⑓ྡ

㻤㻡ṓᮍ‶㻤㻡ṓ௨ୖ ᡭ⾡䞉 ฎ⨨➼䠎 䛺䛧

ᡭ⾡䞉 ฎ⨨➼䠎 䠍䛒䜚

ᡭ⾡䞉 ฎ⨨➼䠎 䠎䛒䜚

ᡭ⾡䞉 ฎ⨨➼䠎 䛺䛧

ᡭ⾡䞉 ฎ⨨➼䠎 䠍䛒䜚

ᡭ⾡䞉 ฎ⨨➼䠎 䠎䛒䜚 䛺䛧

䠍ᆺ䞉ᮎᲈᚠ⎔୙඲䛺䛧㻜㻝㻜㻢㻝㻠㻜㻝㻝㻠 䠎ᆺ䞉ᮎᲈᚠ⎔୙඲䛺䛧㻜㻟㻜㻣㻝㻢㻜㻟㻝㻢 䛭䛾௚䞉ᮎᲈᚠ⎔୙඲䛺䛧㻜㻞㻝㻝㻝㻤㻜㻞㻝㻤 䠍ᆺ䞉ᮎᲈᚠ⎔୙඲䛒䜚㻜㻠㻜㻥㻞㻡㻜㻠㻞㻡 䠎ᆺ䞉ᮎᲈᚠ⎔୙඲䛒䜚㻜㻡㻜㻤㻝㻡㻜㻡㻝㻡 䛭䛾௚䞉ᮎᲈᚠ⎔୙඲䛒䜚㻝㻜㻝㻞㻞㻡㻝㻜㻞㻡 䛒䜚

䠍ᆺ䞉ᮎᲈᚠ⎔୙඲䛺䛧㻜㻝㻞㻜㻜㻝㻞㻜 䠎ᆺ䞉ᮎᲈᚠ⎔୙඲䛺䛧㻜㻟㻝㻥㻜㻟㻝㻥 䛭䛾௚䞉ᮎᲈᚠ⎔୙඲䛺䛧㻜㻞㻞㻝㻜㻞㻞㻝 䠍ᆺ䞉ᮎᲈᚠ⎔୙඲䛒䜚㻞㻡㻞㻞㻞㻡㻞㻞 䠎ᆺ䞉ᮎᲈᚠ⎔୙඲䛒䜚㻝㻣㻞㻟㻝㻣㻞㻟 䛭䛾௚䞉ᮎᲈᚠ⎔୙඲䛒䜚㻝㻟㻞㻠㻝㻟㻞㻠

⢾ᒀ⑓䛾 CCP 䝬䝖䝸䝑䜽䝇ᨵᐃ᱌

ᡭ⾡ᮎᲈᚠ⎔ ୙඲

㻤㻡ṓᮍ‶㻤㻡ṓ௨ୖ ᡭ⾡䞉 ฎ⨨➼䠎 䛺䛧

ᡭ⾡䞉 ฎ⨨➼䠎 䠍䛒䜚

ᡭ⾡䞉 ฎ⨨➼䠎 䠎䛒䜚

ᡭ⾡䞉 ฎ⨨➼䠎 䛺䛧

ᡭ⾡䞉 ฎ⨨➼䠎 䠍䛒䜚

ᡭ⾡䞉 ฎ⨨➼䠎 䠎䛒䜚 䛺䛧䛺䛧㻜㻝㻜㻢㻝㻠㻜㻝㻝㻠 䛒䜚㻜㻠㻜㻥㻞㻡㻜㻠㻞㻡 䛒䜚䛺䛧㻜㻝㻞㻜㻜㻝㻞㻜 䛒䜚㻞㻡㻞㻞㻞㻡㻞㻞

CCP 䝬䝖䝸䝑䜽䝇䛸デ⒪᝟ሗ 1. ๪യ⑓᝟ሗ䛾㔜せᛶ

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⌧⾜䛾ᨭᡶ䛔䛻ᙳ㡪䛧䛺䛔๪യ⑓䜒ศ㢮䛾⢭ ⦓໬䛻ᚲせ

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㐺ṇ䛺യ⑓᝟ሗ䛾グ㘓䛜」㞧ᛶಀᩘ䛺䛹䛾ᶵ ⬟ホ౯䛻ᙳ㡪 2. ṇ☜䛺デ⒪㛵㐃᝟ሗ䛾㔜せᛶ

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㐺ṇ䛺㔜⑕ᗘホ౯䛸ᶵ⬟ホ౯䛻䛴䛺䛜䜛 3. DPC 䝁䞊䝕䜱䞁䜾䛾ṇ☜ᛶ䛾☜ಖ

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᰿ᣐ䛸䛺䜛デ⒪グ㘓䛾㔜せᛶ

±Audit

䛻⪏䛘䜛グ㘓䛸䝁䞊䝕䜱䞁䜾

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䝁䞊䝕䜱䞁䜾䞉䝬䝙䝳䜰䝹➼䛾඘ᐇ

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་⒪ᶵ㛵䝬䝛䝆䝯䞁䝖䛾䛯䜑䛾 DPC 䝕䞊䝍ศᯒ

䠍䠊䜿䞊䝇䝭䝑䜽䝇ศᯒ DPC䛷ㄪᩚ䛧䛯ẚ㍑ศᯒ 䠎䠊デ⒪䝥䝻䝉䝇ศᯒ ヲ⣽䛺デ⒪ᐇែ䛾ྍど໬䛸ẚ㍑ 䠏䠊䜰䜴䝖䜹䝮ศᯒ ་⒪䛾㉁䛾ホ౯䛾ྍ⬟ᛶ 䠐䠊ᆅᇦ䛷䛾ᙺ๭䛾ศᯒ ᶵ⬟ศ໬䛸㐃ᦠ᥎㐍䛾ᇶ♏䝕䞊䝍

デ⒪ሗ㓘ホ౯䛾どⅬ䛸䛧䛶᪤䛻฼⏝ 㛤Ⓨ䛛䜙ᛂ⏝䜈䛸㐍䜏䚸デ⒪ሗ㓘 䜔་⒪ᶵ⬟ホ౯➼䜈฼⏝䛥䜜䜛ẁ 㝵䛻 ᆅᇦ䛻䛚䛡䜛ྛ་⒪ᶵ㛵䛾ᙺ ๭䜢᫂☜䛻䛧䚸་⒪ィ⏬䛺䛹䜈 䛾ᛂ⏝䜒 © K. Fushimi, Tokyo Medical and Dental University

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ྛ⑓㝔䛾㻰㻼㻯䜾䝹䞊䝥䛤䛸䛾䝕䞊䝍䠄⑕౛ᩘ䞉ᅾ㝔᪥ᩘ䠅䜢 ౑䛔䚸඲ᅜᖹᆒ䛸ẚ䜉䚸

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ྠ䛨㻳㼞㼛㼡㼜䛾ᝈ⪅䜢䜘䜚▷䛔ᅾ㝔᪥ᩘ䛷デ⒪䛧䛶䛔䜛 䠄

ຠ⋡ᛶᣦᩘ

䞉ᅾ㝔᪥ᩘ䛾ᣦᶆ䠅

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䜘䜚ᅾ㝔᪥ᩘ䛜㛗䛟䛛䛛䜛ᝈ⪅䜢䛯䛟䛥䜣デ⒪䛧䛶䛔䜛 䠄

」㞧ᛶᣦᩘ

䞉ᝈ⪅ᵓᡂ䛾ᣦᶆ䠅 䛛䜢㻵㼚㼐㼑㼤໬䛧䛶⾲⌧䛧䛯䜒䛾䛷䛒䜛䚹

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ᩘ್䛿㻝䛜඲ᅜᖹᆒ䛸ྠ➼䛷䚸ᩘᏐ䛜኱䛝䛔䜋䛹㧗䛔ホ౯ 䜢୚䛘䜙䜜䜛䚹

㻰㻼㻯䜢౑䛳䛯ຠ⋡ᛶ䚸」㞧ᛶ䛾ホ౯

䐟⑓㝔$'3&ẖ䛾 ᖹᆒᅾ㝔᪥ᩘ䐠⑓㝔$'3&ẖ䛾 ධ㝔ᝈ⪅ᩘ⑓㝔$䛾 ᖹᆒᅾ㝔᪥ᩘ 䐟඲⑓㝔䛾'3&ẖ䛾 ᖹᆒᅾ㝔᪥ᩘ䐠඲⑓㝔䛾'3&ẖ䛾 ධ㝔ᝈ⪅ᩘ඲⑓㝔䛾 ᖹᆒᅾ㝔᪥ᩘ ඲⑓㝔䛾ᝈ⪅ᩘ䛷 ⿵ṇ䛧䛯ᅾ㝔᪥ᩘ

඲⑓㝔䛾ᖹᆒᅾ㝔᪥ᩘ䛷 ⿵ṇ䛧䛯ᅾ㝔᪥ᩘ ຠ⋡ᛶ䛾㐪䛔䜿䞊䝇䞉䝭䝑䜽䝇䛾㐪䛔 <; ;䠖ᝈ⪅ᵓᡂ䛾ᣦᶆ䠄」㞧ᛶᣦᩘ䠅䠈<䠖ᅾ㝔᪥ᩘ䛾ᣦᶆຠ⋡ᛶᣦᩘ 䠖ᝈ⪅ᵓᡂ䛾ᣦᶆ䠄ኚἲ䠅䠈䠖ᅾ㝔᪥ᩘ䛾ᣦᶆ䠄ኚἲ䠅

㻰 㻼 㻯 䜢 ⏝ 䛔 䛯 ຠ ⋡ ᛶ 䞉 」 㞧 ᛶ 䛾 ホ ౯

⑓㝔ᶵ⬟ᨵၿ䛾᪉ἲ 䕿

ຠ⋡ᛶᣦᩘ

䛾⥅⥆ⓗᨵၿ䛿ᛴᛶᮇ⑓㝔䛾䛂⩏ົ䛃

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デ⒪㒊㛛ู䚸⑌ᝈู䛻ලయⓗ䛻ᑐ⟇䜢❧䛶䜛

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▷ᮇධ㝔䛾ᝈ⪅䜢ቑ䜔䛧䛶䜒ᨵၿ䛥䜜䛺䛔䟿

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ᚋ᪉་⒪㐃ᦠ䛾㔜せᛶ 䕿

」㞧ᛶᣦᩘ

䛿⑓㝔ᶵ⬟䜢཯ᫎ䛩䜛㔜せ䛺ᣦᶆ䛸䛺䜛

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ධ㝔ᝈ⪅䜢㑅䜆䛣䛸䛿䛷䛝䛺䛔䛾䛷䚸⡆༢䛻䛿ᨵၿ䛷䛝䛺䛔

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ᑓ㛛ⓗ䛺ᡭ⾡䜔᳨ᰝ䛾ᝈ⪅䜢ቑ䜔䛧䛶ᨵၿ

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๓᪉་⒪㐃ᦠ䜢ᙉ໬䛧䚸⮬㝔䛾≉ᚩ䜢䜘䜚᫂☜໬䛩䜛

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⑓ᗋ✌ാ⋡䛜ୗ䛜䜚䚸㍍⑕ᝈ⪅䛾ධ㝔䛜ቑ䛘䜛䛸పୗ䛩䜛

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ᝈ⪅ᵓᡂ䛾ᣦᶆ䛿ᆅᇦ䛻䛚䛡䜛⑓㝔䛾ᙺ๭䜢཯ᫎ

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デ⒪⛉㻰㻼㻯䝁䞊䝗ᝈ⪅ᩘ⮬㝔䛾 ᖹᆒᅾ㝔᪥ᩘ඲ᅜ䛾 ᝈ⪅ᩘ*1඲ᅜ䛾 ᖹᆒᅾ㝔᪥ᩘ *1 ᾘ໬ჾ⛉㻜㻢㻜㻜㻝㻜㼤㼤㻥㻥㼤㻜㼤㼤㻟㻝㻠㻚㻣㻟㻢㻡㻟㻝㻟㻚㻟 㻜㻢㻜㻜㻝㻜㼤㼤㻥㻥㼤㻝㼤㼤㻝㻞㻡㻚㻜㻢㻝㻠㻞㻣㻚㻤 㻜㻢㻜㻜㻠㻜㼤㼤㻜㻝㻝㻡㼤㼤㻜㻤㻡㻢㻝㻚㻣 ⮬㝔デ⒪⛉ู ᖹᆒᅾ㝔᪥ᩘ

඲ᅜ䛾⑌ᝈᵓ ᡂ䛻⿵ṇ䛧䛯 ሙྜ*2

඲ᅜ䛾ᅾ㝔᪥ ᩘ䛾ᖹᆒ䜢౑ ⏝䛧䛯ሙྜ*3 㻝㻣㻚㻡㻝㻤㻚㻝㻝㻣㻚㻜 ᅾ㝔᪥ᩘ䛾 ᣦᶆ*4ᝈ⪅ᵓᡂ䛾 ᣦᶆ*5 㻜㻚㻥㻣㻜㻚㻥㻠 䠠䠬䠟ホ౯ศ⛉఍䝕䞊䝍 ඲ᅜ䛾⑌ᝈᵓᡂ䛻⿵ṇ䛧䛯ሙྜ䠖⮬㝔䛾㻰㻼㻯ู䛾ᖹᆒᅾ㝔᪥ᩘ䜢඲ᅜ䛾ᝈ⪅ᩘ䛷ຍ㔜ᖹᆒ䛧䛯್ ඲ᅜ䛾ᅾ㝔᪥ᩘ䛾ᖹᆒ䜢౑⏝䛧䛯ሙྜ䠖඲ᅜ䛾㻰㻼㻯ู䛾ᖹᆒᅾ㝔᪥ᩘ䜢⮬㝔䛾ᝈ⪅ᩘ䛷ຍ㔜ᖹᆒ䛧 䛯್ ᅾ㝔᪥ᩘ䛾ᣦᶆ䠖඲ᅜ䛾ᅾ㝔᪥ᩘ䛾ᖹᆒ䜢౑⏝䛧䛯ሙྜ㾂⮬㝔䛾デ⒪⛉ูᖹᆒᅾ㝔᪥ᩘ ᝈ⪅ᵓᡂ䛾ᣦᶆ䠖⮬㝔䛾デ⒪⛉ูᖹᆒᅾ㝔᪥ᩘ㾂඲ᅜ䛾⑌ᝈᵓᡂ䛻⿵ṇ䛧䛯ሙྜ

デ ⒪ ⛉ ู 」 㞧 ᛶ 䞉 ຠ ⋡ ᛶ ศ ᯒ 䛾 ィ ⟬ ᪉ ἲ 40&峕峲峵ସ௬੼峕ঢ়峃峵ীෲ୻ق஍૨ਙ嵣ളහਙك

70'8B40&B72%$ূ਎ୢఐຓఐপ৾भୢ௜॑૭ଳ৲घॊ

ളහਙ嵣஍૨ਙ峘੥ટ岶அ峨島峵ਃચ௬੼બਯ⋜峙୰੹ઽஇ峕ઉ੥峃峵கقڭ岶਴಑ك

஍૨ਙ؟૔੹঩ਯ峘ಢೠ峘౑ৡ峼௬੼ ളහਙ؟೩঻ଡਛ峘୷峼ڭো੹ਊ峴峘ਡਯ峑௬੼

پ஧଍Bਊ੹৸৬峘க

൧௜ఐ౐ਜ਼峑೩঻౐ਜ਼岝൧૵ණীథ౐ਜ਼峘ীෲ૾ய峼઀ં

OKashikaǦ40&

੐ਯ岶଩岮൧௜ఐ峘ਯ க峼੝ఒ峃峵岽峒峑岝୰ ੹બਯ峼঱岼峵岽峒岶峑 岷峵岞

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⫶䛜䜣ᡭ⾡䛻䛚䛡䜛ᢠ⳦⸆ᢞ୚ ᪥ィ⾲

㻌ධ 㻜㻜㻟㻡㻜㻞㻞㻥㻣㻠㻙㻞㻜㻝㻠㻜㻤㻞㻠 㻜㻜㻟㻠㻞㻝㻠㻞㻟㻝㻙㻞㻜㻝㻠㻝㻜㻜㻡 㻜㻜㻟㻟㻠㻜㻡㻠㻤㻤㻙㻞㻜㻝㻡㻜㻞㻝㻤 㻜㻜㻟㻞㻡㻥㻢㻣㻠㻡㻙㻞㻜㻝㻠㻜㻠㻞㻟 㻜㻜㻟㻝㻣㻤㻤㻜㻜㻞㻙㻞㻜㻝㻠㻜㻡㻞㻡 㻜㻜㻟㻜㻥㻣㻥㻞㻡㻥㻙㻞㻜㻝㻠㻝㻞㻜㻝 㻜㻜㻟㻜㻝㻣㻜㻡㻝㻢㻙㻞㻜㻝㻡㻜㻝㻞㻤 㻜㻜㻞㻥㻟㻢㻝㻣㻣㻟㻙㻞㻜㻝㻠㻜㻠㻟㻜 㻜㻜㻞㻤㻡㻡㻟㻜㻟㻜㻙㻞㻜㻝㻠㻜㻣㻟㻜 㻝㻜㻜㻜㻞㻣㻣㻠㻠㻞㻤㻣㻙㻞㻜㻝㻠㻝㻜㻜㻣 㻝㻝㻜㻜㻞㻢㻥㻟㻡㻡㻠㻠㻙㻞㻜㻝㻠㻝㻞㻝㻜 㻝㻞㻜㻜㻞㻢㻝㻞㻢㻤㻜㻝㻙㻞㻜㻝㻠㻜㻠㻜㻥 㻝㻟㻜㻜㻞㻡㻟㻝㻤㻜㻡㻤㻙㻞㻜㻝㻠㻜㻣㻞㻡 㻝㻠㻜㻜㻞㻠㻡㻜㻥㻟㻝㻡㻙㻞㻜㻝㻠㻜㻤㻟㻝 㻝㻡㻜㻜㻞㻟㻣㻜㻜㻡㻣㻞㻙㻞㻜㻝㻠㻝㻝㻝㻞 㻝㻢㻜㻜㻞㻞㻤㻥㻝㻤㻞㻥㻙㻞㻜㻝㻡㻜㻞㻝㻝 㻝㻣㻜㻜㻞㻞㻜㻤㻟㻜㻤㻢㻙㻞㻜㻝㻠㻜㻤㻝㻣 㻝㻤㻜㻜㻞㻝㻞㻣㻠㻟㻠㻟㻙㻞㻜㻝㻠㻜㻥㻜㻣 㻝㻥㻜㻜㻞㻜㻠㻢㻡㻢㻜㻜㻙㻞㻜㻝㻠㻜㻥㻞㻠 㻞㻜㻜㻜㻝㻥㻢㻡㻢㻤㻡㻣㻙㻞㻜㻝㻠㻝㻜㻞㻞 㻞㻝㻜㻜㻝㻤㻤㻠㻤㻝㻝㻠㻙㻞㻜㻝㻠㻝㻝㻜㻥 㻞㻞㻜㻜㻝㻤㻜㻟㻥㻟㻣㻝㻙㻞㻜㻝㻡㻜㻞㻜㻥 㻞㻟㻜㻜㻝㻣㻞㻟㻜㻢㻞㻤㻙㻞㻜㻝㻠㻜㻠㻞㻣 㻞㻠㻜㻜㻝㻢㻠㻞㻝㻤㻤㻡㻙㻞㻜㻝㻠㻝㻝㻝㻥 㻞㻡㻜㻜㻝㻡㻢㻝㻟㻝㻠㻞㻙㻞㻜㻝㻡㻜㻟㻝㻝 㻞㻢㻜㻜㻝㻠㻤㻜㻠㻟㻥㻥㻙㻞㻜㻝㻠㻜㻣㻞㻤 㻞㻣㻜㻜㻝㻟㻥㻥㻡㻢㻡㻢㻙㻞㻜㻝㻠㻜㻤㻞㻣 㻞㻤㻜㻜㻟㻝㻝㻞㻢㻥㻢㻥㻙㻞㻜㻝㻠㻜㻡㻞㻞 㻞㻥㻜㻜㻝㻝㻝㻢㻟㻤㻥㻢㻙㻞㻜㻝㻠㻝㻝㻜㻢 㻟㻜㻜㻜㻟㻠㻞㻝㻥㻤㻣㻠㻙㻞㻜㻝㻠㻜㻝㻜㻢 㻟㻝㻜㻜㻝㻟㻝㻤㻢㻥㻝㻟㻙㻞㻜㻝㻡㻜㻝㻝㻡 㻟㻞㻜㻜㻝㻞㻟㻣㻤㻝㻣㻜㻙㻞㻜㻝㻠㻜㻢㻝㻤 㻟㻟㻜㻜㻝㻝㻡㻢㻥㻠㻞㻣㻙㻞㻜㻝㻠㻝㻜㻝㻡 㻟㻠㻜㻜㻝㻜㻣㻢㻜㻢㻤㻠㻙㻞㻜㻝㻠㻝㻝㻝㻢 㻟㻡㻜㻜㻞㻥㻥㻡㻝㻥㻠㻝㻙㻞㻜㻝㻠㻜㻡㻝㻝 㻟㻢㻜㻜㻟㻥㻝㻠㻟㻝㻥㻤㻙㻞㻜㻝㻠㻜㻤㻜㻡 㻟㻣㻜㻜㻝㻤㻟㻟㻠㻠㻡㻡㻙㻞㻜㻝㻠㻝㻞㻞㻝 㻟㻤㻜㻜㻞㻣㻡㻞㻡㻣㻝㻞㻙㻞㻜㻝㻡㻜㻞㻜㻤 㻟㻥㻜㻜㻟㻢㻣㻝㻢㻥㻢㻥㻙㻞㻜㻝㻠㻜㻡㻞㻣 㻠㻜㻜㻜㻞㻡㻜㻥㻥㻠㻤㻟㻙㻞㻜㻝㻠㻜㻠㻝㻡

᪥ィ⾲䛾ศ㢮 ‡ ᭱ᚋ䛻䚸ᮏ䝉䝭䝘䞊䛾┠ᣦ䛩䛸䛣䜝䛾䜎䛸䜑

176

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㻰㻼㻯䝕䞊䝍䛸䛿ఱ䛛 ‡ ศᯒྍ⬟䛺඲ᅜ⤫୍ᙧᘧ䛾 ᝈ⪅⮫ᗋ᝟ሗ 䠇 デ⒪⾜Ⅽ 䛾㟁Ꮚ䝕䞊䝍䝉䝑䝖 ‡ ᝈ⪅⮫ᗋ᝟ሗ

±

ᝈ⪅ᇶᮏ᝟ሗ

±

⑓ྡ䚸⾡ᘧ䚸ྛ✀䛾䝇䝁䜰䞉䝇䝔䞊䝆ศ㢮 ‡ デ⒪⾜Ⅽ᝟ሗ

±

デ⒪⾜Ⅽ䚸་⸆ရ䚸་⒪ᮦᩱ

±

ᐇ᪋᪥䚸ᅇᩘ䞉ᩘ㔞

±

デ⒪⛉䚸⑓Ჷ䚸ಖ㝤✀ู

1ධ㝔୰䛾䝥䝻䝉䝇 䠄䛔䛴䚸ఱ䜢䚸䛹䜜䛰䛡 ⾜䛳䛯䛾䛛䠅䛜䜟䛛䜛 䠄໭ᾏ㐨኱Ꮫ⸨᳃䠅

DPC 䛾┠ⓗ䛾෌☜ㄆ ‡ ་⒪᝟ሗ䛾ᶆ‽໬䛸㏱᫂໬ ‡ DPC 䛾┠ⓗ䛿䛂ᨭᡶ䛔᪉ᘧ䛾ᨵ㠉䛃䛷䛿䛺䛟 䛂⑓㝔䝬䝛䝆䝯䞁䝖䛾ᨵ㠉䛃

±DPC

䜢⏝䛔䛯

‡

཰ධ⟶⌮

‡

ᨭฟ⟶⌮

‡

ရ㉁⟶⌮

‡

デ⒪䛾᭱㐺໬䛸ពᛮỴᐃᨭ᥼ 䛜㔜せ䛸䛺䜛䚹

(ᯇ⏣䠅

䝁䞁䝃䝹䝔䜱䞁䜾஦ᴗ⪅䛸

DPC

◊✲⌜䛾㐪䛔

ཌປ┬⑓㝔 ไᗘ䛻་⒪䜢㐺ᛂ䛥䛫䜛ᡭἲ஦ᴗ⪅䛾❧ሙ 㒊ศ᭱㐺໬ ‡䝁䝇䝖๐ῶ ‡䜰䝑䝥䝁䞊䝕䜱䞁䜾⌮᝿ⓗ䛺་⒪䛻 ไᗘ䜢㐺ᛂ䛥䛫䜛ศᯒ඲య᭱㐺໬ ‡㏱᫂໬䛸ㄝ᫂㈐௵ ‡ᶆ‽໬䚸ຠ⋡໬䚸㉁䛾ྥୖ

DPC◊✲⌜䛾❧ሙ 1.DPC

䛾┠ⓗ䛾ṇ䛧䛔⌮ゎ

‡

་⒪ไᗘᨵ㠉䛻䛚䛡䜛఩⨨䛵䛡

‡

་⒪᝟ሗ䛾ᶆ‽໬䞉㏱᫂໬䛾䝒䞊䝹䛸䛧䛶䛾

DPC 2.DPC

㛵㐃䝕䞊䝍䛾ά⏝᪉ἲ䛾⌮ゎ

‡

๓ᥦ䛸䛧䛶䛾䛂ṇ䛧䛔䛃䝕䞊䝍సᡂ

‡ICD

DPC

䝁䞊䝕䜱䞁䜾䛾⌮ゎ

‡

㛵㐃᝟ሗ䛾⑓㝔䝬䝛䝆䝯䞁䝖䜈䛾ᛂ⏝

‡

㛵㐃᝟ሗ䛾་⒪䛾㉁⟶⌮䜈䛾ᛂ⏝

z

୺ᙺ䛿ⓙ䛥䜣䛷䛩䚹

‡

䛫䛳䛛䛟䛾ᶵ఍䛷䛩䚹ㅮᖌ䛻䛯䛟䛥䜣㉁ၥ䛧䛶ୗ䛥䛔䚹

‡

Ꮫ䜣䛰䛣䛸䜢䛂䜔䜚᫆䛔䜒䛾䛃䛛䜙䛷䛔䛔䛷䛩䛛䜙䚸⑓㝔䛻 ᖐ䛳䛶ᐇ㊶䛧䛶䜏䛶䛟䛰䛥䛔䚹

‡

ᐇ㊶䛧䛺䛡䜜䜀䚸ᡭἲ䛿㌟䛻䛴䛝䜎䛫䜣䚹

ᮏ䝉䝭䝘䞊䛾┠ⓗ

177

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ᖹᡂ

28

ᖺᗘ

DPC

ኟᏘ䝉䝭䝘䞊䝥䝻䜾䝷䝮

829᪥䠄᭶䠅኱䝩䞊䝹ㅮᖌᑠ䝩䞊䝹 11:15Ͳ12:15௒䜎䛷䛾◊✲⌜䛾ᡂᯝఅぢ11:15Ͳ12:15ExcelDPC䝕䞊䝍ศᯒ䐟 ᫨㣗 13:30Ͳ14:30䝁䞊䝕䜱䞁䜾䛸⑓㝔ᣦᶆ⸨᳃13:30Ͳ14:30BI䝒䞊䝹Tableauධ㛛 14:45Ͳ15:45ᆅᇦ་⒪ศᯒ▼ᕝ14:45Ͳ15:45ᵝᘧ1₇⩦ 16:00Ͳ17:00䝁䞊䝕䜱䞁䜾㜿༡16:00Ͳ17:00DPC䝕䞊䝍ศᯒึ⣭䞉 ⑓㝔ᣦᶆసᡂ 830᪥䠄ⅆ䠅኱䝩䞊䝹ㅮᖌᑠ䝩䞊䝹 10:00Ͳ11:00⮫ᗋ␿Ꮫ◊✲ᗣỌ10:00Ͳ11:00ExcelDPC䝕䞊䝍ศᯒ䐠 11:15Ͳ12:15་⒪䛾㉁ᅧ⃝11:15Ͳ12:15BI䝒䞊䝹Tableauධ㛛 ᫨㣗 13:30Ͳ14:30DPC䛸་⒪䝬䝛䝆䝯䞁䝖ᯇ⏣13:30Ͳ14:30Qliksenceධ㛛 䠄ሙᡤ䠖⚟ᒸ┴໭஑ᕞᕷ⏘ᴗ་⛉኱Ꮫ䠅

178

(17)

170311అぢ⌜ࢭ࣑ࢼ࣮_copy right kMakoto Anan

αʖυΡϱή͹՟ୌ ઔ࡜ҫྏෳࢳ୉ָ ҫྏෳࢳϜϋζϟϱφָ෨ ҫྏ৚ๅָՌ Ѫೈ੥ PDNR#PZNDZDVDNLPDFMS

170311అぢ⌜ࢭ࣑ࢼ࣮_copy right kMakoto Anan 2

䖃ᮏ᪥䛾䛚ヰ 䠍䠊⢭ᗘၥ㢟 䠎䠊ලయⓗ䛺䝁䞊䝕䜱䞁䜾䛾ㄢ㢟 䠏䠊⢭ᗘ䛻ᑐ䛩䜛ᠱᛕ䚸䝁䞊䝕䜱䞁䜾䝔䜻䝇䝖ぢ┤䛧 䠐䠊㻵㻯㻰㻙㻝㻜㻔㻞㻜㻝㻟ᖺ∧䠅䜈䛾ษ䜚᭰䛘

170311అぢ⌜ࢭ࣑ࢼ࣮_copy right kMakoto Anan 3

ฑ੔೧ౕͶ̛̠̚αʖυΡϱή͹੠ౕ໲ୌ ͗ຌݜڂൟΓΕॵΌͱๅࠄ͠Ηͪɽ ฑ੔೧ౕ͹җҽճઅ஖ٝແ෉͜Ͷܪ͗ͮͪɽ

170311అぢ⌜ࢭ࣑ࢼ࣮_copy right kMakoto Anan

䜾䝷䝣䠏䠖᪋タ㢮ᆺูdot9Ⓨ⏕⋡ 㻌㻩㻌㻙㻥㻜㻣㼤㻌㻗㻌㻜㻚㻝㻤 㻌㻩㻌㻞㻱㻙㻜㻡㻌㻗㻌㻜㻚㻟㻣㻞

㻌㻩㻌㻜㻡㼤㻌㻗㻌㻜㻚㻜㻠㻠 㻜㻚

㻝㻜㻚㻜㻑

㻞㻜㻚㻜㻑

㻟㻜㻚㻜㻑

㻠㻜㻚㻜㻑

㻡㻜㻚㻜㻑

㻢㻜㻚㻜㻑

㻣㻜㻚㻜㻑

㻤㻜㻚㻜㻑 㻞㻜㻜㻠㻜㻜㻜㻢㻜㻜㻜㻜㻜㻜㻜㻜㻜㻝㻞㻜㻜㻝㻠㻜㻜㻜㻝㻢㻜㻜

ᖺᨭᡶ⑓㝔 ᖺᨭᡶ⑓㝔 ᖺᨭᡶ⑓㝔 ⥺ᙧ㻌㻔㻝ᖺᨭᡶ⑓㝔㻕 ⥺ᙧ㻌㻔㻝ᖺᨭᡶ⑓㝔㻕 ⥺ᙧ㻌㻔㻝ᖺᨭᡶ⑓㝔㻕

͞͹ࠫͺʃ

ฑ੔೧݆ೖɼ̧̛̚඲Ճ෾Ռճʁࢬઅྪܗพ͹ʰʱ൅ਫ਼ི

179

(18)

170311అぢ⌜ࢭ࣑ࢼ࣮_copy right kMakoto Anan

㼠㻥㼠㻥㼠㻥㼠㻥䠂㼠㻥㼠㻥䠂㼠㻥㼠㻥䠂 㻜㻝㻞㻟㻘㻞㻜㻝㻣㻘㻡㻣㻜㻟㻞㻚㻢㻝㻞㻘㻣㻜㻥㻟㻘㻢㻤㻞㻞㻥㻚㻠㻜㻘㻞㻥㻢㻝㻞㻘㻡㻝㻠㻟㻝㻚㻝㻣㻢㻘㻞㻜㻢㻞㻟㻘㻣㻢㻢㻝㻚 㻜㻞㻞㻣㻘㻠㻤㻜㻥㻘㻝㻠㻜㻟㻟㻚㻟㻣㻘㻠㻥㻝㻞㻘㻤㻜㻣㻟㻣㻚㻞㻝㻘㻥㻣㻟㻤㻘㻜㻠㻞㻟㻢㻚㻢㻡㻢㻘㻥㻠㻠㻝㻥㻘㻥㻤㻥㻡㻚㻝 㻜㻟㻝㻤㻘㻥㻞㻥㻠㻘㻥㻟㻥㻞㻢㻚㻝㻤㻘㻡㻠㻢㻞㻘㻝㻜㻠㻞㻠㻚㻞㻡㻘㻟㻠㻡㻡㻘㻞㻣㻜㻞㻜㻚㻤㻡㻞㻘㻤㻞㻜㻝㻞㻘㻟㻝㻟㻟㻚㻟 㻜㻠㻞㻤㻘㻟㻟㻢㻝㻠㻘㻟㻝㻡㻡㻜㻚㻡㻞㻞㻘㻡㻠㻤㻝㻜㻘㻝㻝㻥㻠㻠㻚㻢㻢㻘㻟㻝㻤㻞㻥㻘㻜㻟㻜㻠㻟㻚㻤㻝㻝㻣㻘㻞㻜㻞㻡㻟㻘㻠㻢㻠㻠㻡㻚㻢 㻜㻡㻟㻟㻘㻟㻡㻜㻝㻝㻘㻢㻢㻜㻟㻡㻚㻜㻝㻥㻘㻥㻠㻢㻤㻘㻞㻡㻥㻠㻝㻚㻡㻤㻘㻡㻥㻤㻞㻜㻘㻟㻤㻠㻟㻠㻚㻤㻝㻝㻝㻘㻤㻥㻠㻠㻜㻘㻟㻜㻟㻢㻚㻜 㻜㻢㻢㻟㻘㻠㻣㻟㻝㻡㻘㻠㻥㻝㻞㻠㻚㻠㻠㻞㻘㻢㻡㻟㻥㻘㻜㻡㻢㻞㻝㻚㻝㻞㻢㻘㻥㻥㻤㻞㻢㻘㻝㻠㻠㻞㻜㻚㻢㻞㻟㻟㻘㻝㻞㻠㻡㻜㻘㻢㻥㻝㻞㻝㻚㻣 㻜㻣㻞㻠㻘㻡㻞㻠㻥㻘㻜㻞㻠㻟㻢㻚㻤㻥㻘㻝㻝㻠㻝㻘㻥㻠㻝㻞㻝㻚㻞㻣㻘㻣㻤㻡㻢㻘㻤㻠㻜㻞㻠㻚㻢㻢㻝㻘㻠㻞㻟㻝㻣㻘㻤㻜㻡㻥㻚㻜 㻜㻤㻠㻘㻣㻞㻜㻝㻘㻥㻝㻢㻠㻜㻚㻢㻞㻘㻝㻤㻤㻣㻞㻣㻟㻟㻚㻢㻘㻠㻟㻥㻞㻘㻟㻞㻤㻟㻢㻚㻞㻝㻟㻘㻟㻠㻣㻠㻘㻥㻣㻝㻣㻚㻞 㻜㻥㻠㻘㻤㻥㻢㻟㻘㻝㻜㻞㻢㻟㻚㻠㻞㻘㻞㻠㻜㻥㻢㻡㻠㻟㻚㻢㻘㻤㻥㻢㻞㻘㻡㻡㻤㻟㻣㻚㻝㻝㻠㻘㻜㻟㻞㻢㻘㻢㻞㻡㻣㻚㻞 㻝㻜㻝㻟㻘㻤㻡㻜㻞㻘㻟㻤㻝㻝㻣㻚㻞㻢㻘㻝㻞㻠㻝㻘㻠㻣㻥㻞㻠㻚㻝㻣㻘㻤㻞㻞㻟㻘㻥㻠㻜㻞㻞㻚㻝㻟㻣㻘㻣㻥㻢㻣㻘㻤㻜㻜㻜㻚㻢 㻝㻝㻞㻡㻘㻣㻟㻥㻤㻘㻝㻡㻡㻟㻝㻚㻣㻝㻢㻘㻝㻝㻝㻟㻘㻥㻤㻡㻞㻠㻚㻠㻢㻘㻡㻡㻞㻥㻘㻠㻤㻝㻞㻜㻚㻠㻤㻤㻘㻠㻜㻞㻞㻝㻘㻢㻞㻝㻠㻚㻡 㻝㻞㻞㻣㻘㻥㻠㻣㻥㻘㻟㻝㻢㻟㻟㻚㻟㻝㻜㻘㻣㻥㻢㻞㻘㻝㻢㻤㻞㻜㻚㻟㻞㻘㻥㻝㻡㻣㻘㻡㻜㻢㻞㻞㻚㻤㻣㻝㻘㻢㻡㻤㻝㻤㻘㻥㻥㻜㻢㻚㻡 㻝㻟㻥㻘㻥㻞㻞㻟㻘㻝㻥㻠㻟㻞㻚㻞㻠㻘㻢㻝㻤㻝㻘㻝㻝㻤㻞㻠㻚㻝㻞㻘㻟㻢㻜㻟㻘㻢㻡㻝㻞㻥㻚㻡㻞㻢㻘㻥㻜㻜㻣㻘㻥㻢㻟㻥㻚㻢 㻝㻠㻝㻝㻘㻝㻤㻠㻞㻘㻝㻝㻞㻝㻤㻚㻥㻟㻘㻣㻤㻞㻣㻞㻣㻝㻥㻚㻥㻘㻝㻜㻠㻞㻘㻝㻣㻜㻞㻟㻚㻤㻞㻠㻘㻜㻣㻜㻡㻘㻜㻜㻥㻜㻚㻤 㻝㻡㻞㻘㻥㻢㻥㻞㻢㻤㻥㻚㻜㻠㻘㻠㻢㻣㻠㻡㻡㻝㻜㻚㻝㻞㻘㻠㻢㻢㻝㻘㻞㻢㻡㻝㻜㻚㻝㻝㻥㻘㻥㻜㻞㻝㻘㻥㻤㻤㻜㻚㻜 㻝㻢㻞㻜㻘㻥㻜㻝㻟㻘㻢㻞㻢㻝㻣㻚㻟㻝㻡㻘㻝㻡㻞㻞㻘㻝㻡㻣㻝㻠㻚㻠㻡㻘㻣㻟㻠㻢㻘㻡㻣㻢㻝㻠㻚㻠㻤㻝㻘㻣㻤㻣㻝㻞㻘㻟㻡㻥㻡㻚㻝 ⥲ィ㻟㻠㻝㻘㻠㻞㻝㻝㻜㻢㻘㻞㻜㻥㻟㻝㻚㻝㻝㻤㻤㻘㻠㻤㻡㻡㻝㻘㻣㻠㻥㻞㻣㻚㻡㻡㻣㻘㻢㻜㻝㻝㻠㻣㻘㻢㻥㻥㻞㻢㻚㻡㻝㻘㻜㻤㻣㻘㻡㻜㻜㻡㻘㻢㻡㻣㻤㻚㻝

㻯ᑐ㇟⑓㝔㻢ᖺᨭᡶ⑓㝔㻝㻤ᖺᨭᡶ⑓㝔 ᪋タ✀ููMDCdot9Ⓨ⏕⋡ 㻜㻚

㻝㻜㻚㻜

㻞㻜㻚㻜

㻟㻜㻚㻜

㻠㻜㻚㻜

㻡㻜㻚㻜

㻢㻜㻚㻜

㻣㻜㻚㻜 㻜㻝

㻜㻞 㻜㻟 㻜㻠 㻜㻡 㻜㻢 㻜㻣 㻜㻤 㻜㻥 㻝㻜 㻝㻝 㻝㻞 㻝㻟 㻝㻠 㻝㻡 㻝㻢

ᖺᨭᡶ⑓㝔 ᖺᨭᡶ⑓㝔 ᖺᨭᡶ⑓㝔

ฑ੔೧݆ೖɼ̧̛̚඲Ճ෾Ռճʁࢬઅྪܗพ͹0'&พʰʱ൅ਫ਼ ݼٷح೗๬

Ν௔ ͓ͪ΍͹

170311అぢ⌜ࢭ࣑ࢼ࣮_copy right kMakoto

䠟㻡㻜䚷䚷ஙᡣ䛾ᝏ ᛶ ᪂⏕≀ 䚷䠟㻡㻜㻚 㻜䚷䚷ங㢌㒊ཬ䜃ங㍯ 䚷䠟㻡㻜㻚 㻝䚷䚷ஙᡣ୰ኸ㒊 䚷䠟㻡㻜㻚 㻞䚷䚷ஙᡣୖෆഃ䠐ศ䛾䠍 䚷䠟㻡㻜㻚 㻟䚷䚷ஙᡣୗෆഃ䠐ศ䛾䠍 䚷䠟㻡㻜㻚 㻠䚷䚷ஙᡣୖእഃ䠐ศ䛾䠍 䚷䠟㻡㻜㻚 㻡䚷䚷ஙᡣୗእഃ䠐ศ䛾䠍 䚷䠟㻡 㻜㻚㻢 䚷䚷ங⭢⭆ ❐ᑿ㒊㻨㻭㼤 㼕㼘㼘 㼍㼞 㼥㻌㼠 㼍㼕㼘 㻌㼛㼒㻌 㼎㼞㼑 㼍㼟㼠 㻪 䚷䠟㻡㻜㻚 㻤䚷䚷ஙᡣ䛾ቃ⏺㒊⑓ᕢ 䚷䠟㻡㻜㻚 㻥䚷䚷ஙᡣ䠈㒊఩୙᫂

ٛ໲ʁघढ़Ν͢ͱ͏͵͗ Δɼ৆ࡋ෨Ғ͗෈໎ͳ͏ ͑͞ͳ͍͗Ζ͹͖ʀʀʃ 170311అぢ⌜ࢭ࣑ࢼ࣮_copy right kMakoto Anan 7

ᅗ⾲䠏㻹㻰㻯ู䛂㻚㻥䛃Ⓨ⏕⋡ 㻜㻑㻡㻑㻝㻜㻑

㻝㻡㻑

㻞㻜㻑

㻞㻡㻑

㻟㻜㻑

㻟㻡㻑

㻠㻜㻑

㻠㻡㻑

㻡㻜㻑 㻜㻝㻜㻞㻜㻟㻜㻠㻜㻡㻜㻢㻜㻣㻜㻤㻜㻥㻝㻜㻝㻝㻝㻞㻝㻟㻝㻠㻝㻡㻝㻢㻝㻣㻝㻤

㼐㼜㼠㻥㻑㻔㻞㻞㻕 㼐㼜㼠㻥㻑㻔㻞㻞㻕 㼐㼜㼠㻥㻑㻔㻞㻝㻕 㼐㼜㼠㻥㻑㻔㻞㻝㻕 㼐㼜㼠㻥㻑㻔㻞㻜㻕 㼐㼜㼠㻥㻑㻔㻞㻜㻕 㼐㼜㼠㻥㻑㻔㻝㻥㻕 㼐㼜㼠㻥㻑㻔㻝㻥㻕 㼐㼜㼠㻥㻑㻔㻝㻤㻕 㼐㼜㼠㻥㻑㻔㻝㻤㻕

170311అぢ⌜ࢭ࣑ࢼ࣮_copy right kMakoto ʤ̏ʥฑ੔೧Ոʁ޲ਫ਼঴Ͷͱࢾߨݗ౾җҽճ౵͗ૌ৭͠ΗΖ ˢ0(',6͹υʖν͹,&'෾ྪͶͯ͏ͱ໲͏߻Κ͍ͦ͗Ζɽ ʤ̐ʥʛฑ੔೧݆ʁࢾߨͶͯ͏ͱ͹ݗ౾ɼ६ඍ ʤ̑ʥฑ੔೧݆ʛʁࢾߨ֋࢟ˢฑ੔೧ౕɼ຿ؔබӅͶ΍֨୉ ʤ̒ʥฑ੔೧ౕʁබ໌෉༫͹ཻқ఼ݜڂൟˢʰউබ໌෉༫͹ཻқ ఼ϜωϣΠϩࡠ੔ʤ,&'͹எࣟ΍෕ٶͦ͠Ζʥʱʁસࠅࢾߨ බӅͶ޲ਫ਼঴͖Δഓා ˢඬ६Կ౵΃͹Πϕϫʖοˢ0(',6බ໌ɼϪιుࢋබ໌͹ݡ௜͢ɼ බ໌ඬ६Կ౵ɼ৯ʓ͵٠࿨ً͗ͪ͘ɽ ˠͯΉΕझʓ͹՟ୌͺ'3&੏ౕ಍೘ɼͨΗҐ઴͖Δ͍ͮͪɽ ؈ୱͶ͏͑ͳɼड़པࣆͺ૟ఈ಼ɽ

˙ʰೖຌ൝̛̩̞ʙ̧̧̪͹ࢾߨʱͳ՟ୌ

180

(19)

170311అぢ⌜ࢭ࣑ࢼ࣮_copy right kMakoto Anan

˘'3&ਏஇ܊ʥ෾ྪ݀ఈ͹خຌܙ ҫྏࣁݱΝ࠹΍౦೘ͪ͢উබ໌͹મ୔ ,&'Ͳఈٝ ࣰࢬͪ͢घढ़ .αʖχͲఈٝ ෯উබ໌ɼึঁྏ๑ɼ॑঳ౕ౵͹གྷો ݀ఈ

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170311అぢ⌜ࢭ࣑ࢼ࣮_copy right kMakoto Anan 10

˘উබ໌ͺʰߡ͓๏ʱ͖ͫΔɼ໿ղ͵՟ୌͲ͍Ζ

̏ʥʰࣆࣰʱ͹ఈٝͺրવ͗༲ҝɼʰߡ͓๏ʱ͹ఈٝͺೋ͢͏ ˢཀྵմΏқࣟΝ౹ҲͤΖ͹ͺ୉ร ˢຌཔͺʰਏྏى࿧ʱ͗ͨ͹ࠞڎͳ͵Ζ͗ɼਏྏى࿧ͨ͹΍͹͗ αʖυΡϱήͤΖͶॉ෾͵ࡒྋͳͺ͵Δ͵͏ʀʀʀɽ ˠ͞͹໲ୌͶଲ͢ͱɼฑ੔೧౲͖࣎ΔؖܐंͺրવͶ౔ྙ͢ɼݳࡑ ͹αʖυΡϱήτΫηφ΍ಋ༹͹қਦΝ࣍ͮͱ͏Ζɽ 170311అぢ⌜ࢭ࣑ࢼ࣮_copy right kMakoto Anan 11

❶,&'ศ㢮␃ពⅬ ,㸿-㹀㸷ឤᰁ⑕ཬࡧᐤ⏕⹸ᒁᡤឤᰁࡣ㝖ࡁཎᅉ⳦ࠊ⑓ཎయࢆグ㍕㸦ፎྜేࠊ࿘⏘ᮇ㝖ࡃ ,,㹁-㹂㸲㸶᪂Ⰻᛶࠊᝏᛶࡢ༊ูࠊ㒊఩ᛶ≧ࠊୖ⓶ᛶࠊཎⓎᕢ㸦㌿⛣ࡢሙྜ㸧⾡ᚋࠊ἞⒪ᚋ ㍕ࠊ༢࡞⭘ࡣ᪂⏕≀࡛ࡣ࡞ὀព ,,,㹂-㹂㸶⾑ᾮ࠾㐀⾑ჾࡢ⑌ᝈ࡞ච␿ᶵᵓࡢ 㞀ᐖ⸆๣➼ࡢእᅉ࡟㉳ᅉࡍྜࡣࡑࡢཎᅉࢆ ,9㹃-㸮ෆᰤ㣴࠾ㅰ⑌ᝈ⸆๣➼ࡢእᅉ࡟㉳ᅉࡍྜࡣࡑࡢཎᅉࢆ 9㹄-⢭⚄࠾⾜ືࡢ㞀ᐖヲ⣽࡞ᆺࡢグ㍕,&'ࡢᡂ᭩ࢆཧ↷ࡍ 9,-㹅㸷⚄⤒⣔ࡢ⑌㑇ఏᛶࠊኚᛶ⑌ᝈࠊࡢ௚ࡢ㞀ᐖࠊᛴᛶ࠿ᚋ㑇⑕࠿ࡢ༊ู 9,,㹆-㹆㸳║࠾௜ᒓჾࡢ⑌ᝈᕥྑࠊ୧ഃࢆ᫂♧ 9,,,㹆-㹆㸷⪥࠾ஙᵝ✺㉳ࡢ⑌ᝈᛴᛶ ,;㹇-㹇㸷ᚠ⎔ჾ⣔ࡢ⑌ᝈᛶࠊ㧗⾑ᅽᛶࠊᛴᛶளᛴᛶࠊ㝞ᪧᛶࡢ᫂♧ ;㹈-࿧྾ჾ⣔ࡢ⑌ᝈᛴᛶࠊ៏ᛶࡢ༊ูࠊཎయࡢグ㍕ ;,-㹉㸷ᾘ໬ჾ⣔ࡢ⑌ᝈᛴᛶࠊ៏ᛶࡢ༊ูࠊཎయࡢグ㍕ヲ⣽఩ࡢ ;,,㹊-⓶⭵࠾⓶ୗ⤌⧊ࡢ⑌ᝈ㒊఩ࡢグ㍕ࠊᰁᛶࡢሙྜࡣཎᅉ⳦ࠊ⑓ཎయࡢグ㍕ ;,,,㹋-㹋㸷➽㦵᱁⣔࠾ྜ⤌⧊⑓ኚ㒊఩ࡢグ㍕ࠊ⚄⤒㞀ᐖࡢ᭷↓ࠊ᪂㩭ᦆയ㝞ᪧᛶࡢ༊ู

⑓ྡ௜୚ࡢ␃ពⅬࡢ୍౛

170311అぢ⌜ࢭ࣑ࢼ࣮_copy right kMakoto Anan

˙ฑ੔೧ౕΉͲ͹ɼαʖυΡϱήΪ΢χͶؖͤΖಊ͘

ˠݳࡑͲͺαʖυΡϱήτΫηφɽҐԾɼ'3&඲Ճ෾Ռճ͹ࣁྋΓΕ ɿܨҤ ˕ਏஇ܊෾ྪ͹મ୔Ͷͯ͏ͱͺɼҲఈ͹ϩʖϩͶخͰ͏ͱक࣑ҫ͹ҫ ָద͵൓இͲαʖυΡϱήͤΖ͞ͳͳ͠Ηͱ͏Ζ͗ɼαʖυΡϱήͶ ؖͤΖ৆ࡋ͵ࢨਓ౵ͺ͵͚ɼฑ੔೧݆̒ೖ'3&඲Ճ෾ՌճͶ͕ ͏ͱ ʀࣆྭͶΓͮͱͺ෈న઀͵αʖυΡϱή͗ࢆݡ͠ΗΖ ʀαʖυΡϱή͹࣯͗ҫྏؽؖ͟ͳͶ୉͚͍ࠫ͗͘Ζɼͳ͏ͮͪࢨఢ ͗͵͠Ηͪͳ͞Θɽ ˕'3&඲Ճ෾ՌճͶ͕͏ͱͺ͞͹ࢨఢΝಁΉ͓'3&3'36αʖυΡ ϱήͶؖͤΖϜωϣΠϩΝ'3&ݜڂൟͲࡠ੔͢ͱ΍Δ͑͞ͳͳͪ͢ɽ ̐ɿ'3&αʖυΡϱήϜωϣΠϩ͹ࠕޛ͹खѽ͏Ͷͯ͏ͱҌ ݳࡑɼ'3&αʖυΡϱήͶؖͤΖϜωϣΠϩҌ͹ࡠ੔͗਒ΞͲ͏Ζͳ ͞ΘͲ͍Ζ͗ɼ౲֚ϜωϣΠϩҌͺӀ͘କ͘'3&඲Ճ෾ՌճͲ಼༲͹ ݗ౾Νߨͮͪ৏Ͳɼࢾߨ൝ΝखΕΉͳΌɼ'3&බӅ΃৚ๅ఑ڛΝߨ͑ ͞ͳͳ͢ͱͺʹ͖͑ɽ

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Simon, Herbert A., (997, Administrative Behavior: A Study of Decision-Making Processes in Administrative Organizations,Fourth Edition, New York :

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