本研究は, 病院管理責任者各々の病院経営に対する現状認識の共通性やズレ, 各部門の病院経営改善への取り組みの実態を把握し分析することを目的に実施した。調査協力を得られた施設は, 広島県下100床以上の一般病院111施設中15施設(13.3%)で, 経営指標の回答のあった13施設のうち, 医業収支比率100%未満の病院は4施設, 100%以上の病院は9施設であった。病院が経営改善に向けて実行した新規事業の内容は, 介護保健の施行を見据えた, 療養型病床群への転換・拡充, 在宅介護支援センターの新設, 訪問看護ステーションの新設, 病院内のアメニティーの充実などであった。病院経営に関連する入院患者数・外来患者数の変化を認識している管理責任者は事務部長, 病院長, 看護部長の順であった。病院経営・医療サービスに向けて病院全体で取り組む中長期目標, 最優先取り組み, 次年度目標に対しても, 各々の部門の管理責任者3者が一致していたのは3者ともに回答のあった13施設中4施設のみであった。今回の調査より, 病院経営に対する管理責任者の認識の不一致と職務内容や職能上の立場が優先する病院組織の実態の一部が明らかになった。

The purpose of this study is to understand and analyse common or different awareness of the actual conditions of hospital administration among the management of hospitals, and the present state of approaches of each department to improvement of hospital administration. The institutions that supported this research are 15 out of the 111 general hospitals with more than 100 beds in them in Hiroshima Prefecture (13.3%). Among 13 institutions that have provided data to the management index, the hospitals under 100% revenue and expenditure rate of medical practice are 4,and the institutions more than 100% are 9. The contents of new projects that the hospitals have carried out toward improving their administration include, consideration of changes in the administration of nursing care insurance, changing into or enlarging into convalescent hospitals, the establishment of home care support centers, founding visiting care stations and upgrading amenities in hospitals. With regard to levels of awareness of the effect of changing numbers of inpatient and outpatient on hospital administration, head office directors are first, directors of hospitals second and then directors of nursing. he number of institutions where all three directors of departments gave answers is 13. In four out of the 13 institutions, the three directors all agree on medium and long term aims, the efforts to be given highest priorities and the aim for the next year of their hospital administration/medical service. This research shows clearly differing levels of awareness, which very depending on differing job specifications and professional functions within the actual circumstances of hospital systems.

国立情報学研究所で電子化