{"id":639,"date":"2011-03-16T10:10:02","date_gmt":"2011-03-16T01:10:02","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=639"},"modified":"2015-08-07T13:26:26","modified_gmt":"2015-08-07T04:26:26","slug":"%e5%9b%bd%e6%b0%91%e7%9a%86%e4%bf%9d%e9%99%ba%e3%80%81%e3%83%95%e3%83%aa%e3%83%bc%e3%82%a2%e3%82%af%e3%82%bb%e3%82%b9%e3%81%a8%e3%81%84%e3%81%86%e5%8c%bb%e7%99%82%e5%88%b6%e5%ba%a6%e4%b8%8b%e3%81%ab","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=639","title":{"rendered":"\u56fd\u6c11\u7686\u4fdd\u967a\u3001\u30d5\u30ea\u30fc\u30a2\u30af\u30bb\u30b9\u3068\u3044\u3046\u533b\u7642\u5236\u5ea6\u4e0b\u306b\u304a\u3044\u3066\u3082\u30b1\u30a2\u306e\u7d99\u7d9a\u6027\u3092\u4fdd\u3064\u3053\u3068\u306f\u300c\u907f\u3051\u3089\u308c\u308b\u300d\u5165\u9662\u3092\u6e1b\u3089\u3059"},"content":{"rendered":"

\u3010\u6587\u732e\u540d\u3011
\nShou-Hsia Cheng, et al. : A longitudinal examination of continuity of care and avoidable hospitalization. Evidence from universal coverage health care system. Arch Intern Med: 170(18): 1671-1677.
\n\u00a0
\n\u3010\u8981\u7d04\u3011
\n\uff1c\u80cc\u666f\u3068\u76ee\u7684\uff1e
\n\u53f0\u6e7e\u306f\uff11\uff19\uff19\uff15\u5e74\u306b\u7686\u4fdd\u967a\u5236\u5ea6\u3092\u5c0e\u5165\u3057\u3001\uff19\uff19\uff05\u306e\u56fd\u6c11\u304c\u52a0\u5165\u3057\u3066\u3044\u308b\u3002\u5bb6\u5ead\u533b\u7642\u79d1\u306f\uff12\uff13\u3042\u308b\u5c02\u9580\u8a3a\u7642\u79d1\u306e\uff11\u3064\u3068\u4f4d\u7f6e\u3065\u3051\u3089\u308c\u3001\u56fd\u6c11\u306f\u81ea\u5206\u306e\u75c7\u72b6\u306b\u5408\u308f\u305b\u3066\u81ea\u7531\u306b\u8a3a\u7642\u79d1\u3092\u9078\u3073\u7d39\u4ecb\u72b6\u306a\u3057\u3067\u53d7\u8a3a\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u308b\u3002\u56fd\u6c11\uff11\u4eba\u3042\u305f\u308a\u306e\u53d7\u8a3a\u983b\u5ea6\u306f15\u56de\/\u5e74\u3068\u4e16\u754c\u3067\u6700\u3082\u9ad8\u3044\u56fd\u306e\u4e00\u3064\u3067\u3042\u308a\u3001\u53f0\u6e7e\u56fd\u6c11\u306e\u53d7\u7642\u884c\u52d5\u306f\u300c\u30c9\u30af\u30bf\u30fc\u30b7\u30e7\u30c3\u30d4\u30f3\u30b0\u300d\u3068\u6279\u5224\u3092\u53d7\u3051\u308b\u3053\u3068\u3082\u3042\u308b\u3002\u3053\u306e\u3088\u3046\u306a\u74b0\u5883\u306f\u60a3\u8005\u3068\u533b\u5e2b\u306e\u30b3\u30df\u30e5\u30cb\u30b1\u30fc\u30b7\u30e7\u30f3\u3084\u4fe1\u983c\u95a2\u4fc2\u3084\u30b1\u30a2\u306e\u7d99\u7d9a\u6027\u3092\u640d\u306a\u3044\u3084\u3059\u3044\u3002\u5148\u884c\u7814\u7a76\u3067\u306f\u30b1\u30a2\u306e\u7d99\u7d9a\u6027\u3092\u9ad8\u3081\u308b\u3053\u3068\u304cER\u306e\u53d7\u8a3a\u3092\u6e1b\u3089\u3059\u3053\u3068\u3001\u75be\u75c5\u306e\u4e88\u9632\u304c\u9032\u3081\u3089\u308c\u308b\u3053\u3068\u3001\u5165\u9662\u3092\u6e1b\u3089\u3059\u3053\u3068\u3001\u6162\u6027\u75be\u60a3\u306e\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u304c\u6539\u5584\u3059\u308b\u3053\u3068\u3001ICU\u306e\u5229\u7528\u304c\u6e1b\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u3066\u3044\u308b\u304c\u300c\u907f\u3051\u3089\u308c\u308b\u5165\u9662\u300d\u306b\u3064\u3044\u3066\u306f\u7814\u7a76\u3055\u308c\u3066\u3044\u306a\u3044\u3002\u4e00\u65b9\u3067\u300c\u907f\u3051\u3089\u308c\u308b\u5165\u9662\u300d\u3068\u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u3068\u306e\u95a2\u9023\u306f\u7814\u7a76\u3055\u308c\u3066\u3044\u308b\u304c\u3001\u30b1\u30a2\u306e\u7d99\u7d9a\u6027\u3068\u306e\u95a2\u9023\u3092\u7814\u7a76\u3057\u305f\u3082\u306e\u306f\u5c11\u306a\u304f\u3001\u5341\u5206\u306a\u7d50\u679c\u306f\u5f97\u3089\u308c\u3066\u3044\u306a\u3044\u3002\u3053\u306e\u7814\u7a76\u3067\u306f\u53f0\u6e7e\u306e\u533b\u7642\u74b0\u5883\u306b\u304a\u3051\u308b\u30b1\u30a2\u306e\u7d99\u7d9a\u6027\u306e\u300c\u907f\u3051\u3089\u308c\u308b\u5165\u9662\u300d\u306b\u5bfe\u3059\u308b\u5f71\u97ff\u3092\u77e5\u308b\u3053\u3068\u3092\u76ee\u7684\u3068\u3057\u3066\u3044\u308b\u3002<\/p>\n

\uff1c\u65b9\u6cd5\uff1e
\n2000\u5e741\u67081\u65e5\u304b\u30892006\u5e7412\u670831\u65e5\u306e\u671f\u9593\u3001\u5065\u5eb7\u4fdd\u967a\u3078\u306e\u8acb\u6c42\u30c7\u30fc\u30bf\u304b\u3089\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u306e\u5229\u7528\u72b6\u6cc1\u3092\u8abf\u67fb\u3057\u305f\u3002\u3053\u306e\u671f\u9593\u306b3\u540d\u4ee5\u4e0a\u306e\u533b\u5e2b\u3092\u5229\u7528\u3057\u305f30830\u4eba\u306e\u60a3\u8005\u304c\u30e9\u30f3\u30c0\u30e0\u306b\u9078\u629e\u3055\u308c\u30013\u3064\u306e\u5e74\u9f62\u5c64\u306b\u5206\u3051\u3066\u89e3\u6790\u3057\u305f\u3002\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u907f\u3051\u3089\u308c\u308b\u5165\u9662\u3068\u5168\u3066\u306e\u5165\u9662\u3068\u3057\u305f\u3002\u5e74\u9f62\u3001\u6027\u5225\u3001\u4f4e\u6240\u5f97\u304b\u3069\u3046\u304b\u3001\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306e\u5065\u5eb7\u72b6\u614b\u3001time effect\u3001random subject effect\u3092\u8abf\u6574\u3059\u308b\u305f\u3081\u306brandom intercept logistic regression model\u3092\u5229\u7528\u3057\u305f\u3002
\n\u30b1\u30a2\u306e\u7d99\u7d9a\u6027\u306e\u6307\u6a19\u306fContinuity of care index (COCI)\u3092\u7528\u3044\u305f\u3002
\nCOCI\u306f\u60a3\u8005\u304c\u304b\u304b\u3063\u305f\u533b\u5e2b\u306e\u6570\u3068\u305d\u308c\u305e\u308c\u306e\u533b\u5e2b\u306b\u53d7\u8a3a\u3057\u305f\u6570\u304b\u3089\u306a\u308b\u5f0f\u3067\u793a\u3055\u308c\u308b\u3002
\nCOCI\uff1d(\u03a3\uff4ej2\uff0dN\uff09\/N\uff08N\uff0d1\uff09\uff08\u03a3\u306e\u4e0b\u306bj=1\uff0c\u4e0a\u306bM\uff09
\nN\u306f\u533b\u5e2b\u306b\u53d7\u8a3a\u3057\u305f\u7dcf\u56de\u6570\u3001\uff4ej\u306f\uff11\u4eba\u306e\u533b\u5e2b\u3092\u53d7\u8a3a\u3057\u305f\u56de\u6570\u3001j\u306f\u533b\u5e2b\u306e\u756a\u53f7\u3001M\u306f\u533b\u5e2b\u306e\u6570\u3002
\nCOCI\u306f0-1\u306e\u9593\u306e\u6570\u5024\u3067\u8868\u3055\u308c\u3001\uff11\u306b\u8fd1\u3044\u307b\u3069\u30b1\u30a2\u306e\u7d99\u7d9a\u6027\u304c\u9ad8\u3044\u3001\u3068\u3055\u308c\u308b\u3002
\nCOCI\u81ea\u8eab\u306b\u672c\u6765\u7684\u306a\u610f\u5473\u306f\u306a\u3044\u305f\u3081\u3001\u3053\u306e\u7814\u7a76\u3067\u306f\u5bfe\u8c61\u3068\u306a\u3063\u305f\u60a3\u8005\u306eCOCI\u5024\u306e\u5206\u5e03\u3092\u5143\u306b0.00-0.16\u3092low\u30010.17-0.33\u3092medium\u30010.34-1.00\u3092high\u3068\u3057\u305f\u3002
\n\u300c\u907f\u3051\u3089\u308c\u308b\u5165\u9662\u300d\u306fIOM\uff08institute of medicine\uff09\u306b\u3088\u308b\u5b9a\u7fa9\u3092\u7528\u3044\u305f\u3002<\/p>\n

\uff1c\u7d50\u679c\uff1e
\n\uff13\u3064\u5168\u3066\u306e\u5e74\u9f62\u5c64\u306b\u304a\u3044\u3066COCI\u304c\u9ad8\u3051\u308c\u3070\u907f\u3051\u3089\u308c\u308b\u5165\u9662\u304c\u767a\u751f\u3059\u308b\u53ef\u80fd\u6027\u306f\u4f4e\u304b\u3063\u305f\u3002
\n\u5168\u3066\u306e\u5165\u9662\u306b\u304a\u3044\u3066\u3082\u540c\u69d8\u3067\u3042\u3063\u305f\u3002<\/p>\n

Table3 \u3088\u308a\u629c\u7c8b\u3000\u907f\u3051\u3089\u308c\u308b\u5165\u9662\u3068COCI\u306e\u95a2\u9023
\n\u00a0
\n\"110316_1\"<\/a><\/p>\n

Table\uff14\u3000\u3088\u308a\u629c\u7c8b\u3000\u5165\u9662\u5168\u4f53\u3068COCI\u306e\u95a2\u9023
\n\u00a0
\n\"110316_2\"<\/a><\/p>\n

\uff1c\u7d50\u8ad6\uff1e
\n\u30d5\u30ea\u30fc\u30a2\u30af\u30bb\u30b9\uff08\u3053\u306e\u8ad6\u6587\u3067\u306feasy access to care\u3068\u8a18\u8f09\uff09\u306e\u74b0\u5883\u4e0b\u306b\u304a\u3044\u3066\u3082\u30b1\u30a2\u306e\u7d99\u7d9a\u6027\u3092\u826f\u597d\u306b\u4fdd\u3064\u3053\u3068\u306f\u907f\u3051\u3089\u308c\u308b\u5165\u9662\u3001\u5165\u9662\u5168\u4f53\u3092\u6e1b\u3089\u3059\u3053\u3068\u306b\u3064\u306a\u304c\u308b\u3002\u30b1\u30a2\u306e\u7d99\u7d9a\u6027\u3092\u6539\u5584\u3059\u308b\u3053\u3068\u304c\u7686\u4fdd\u967a\u5236\u5ea6\u306e\u4e2d\u306b\u7f6e\u3044\u3066\u3082\u6709\u52b9\u306a\u6226\u7565\u3068\u3044\u3048\u308b\u3002
\n\u00a0
\n\u3010\u8003\u5bdf\u30fb\u30c7\u30a3\u30b9\u30ab\u30c3\u30b7\u30e7\u30f3\u3011
\n\u53f0\u6e7e\u3068\u540c\u69d8\u306b\u7686\u4fdd\u967a\u5236\u5ea6\u30fb\u30d5\u30ea\u30fc\u30a2\u30af\u30bb\u30b9\u306e\u30b7\u30b9\u30c6\u30e0\u3092\u53d6\u308b\u65e5\u672c\u306b\u304a\u3044\u3066\u3082\u3001\u30b1\u30a2\u306e\u7d99\u7d9a\u6027\uff08COCI\uff09\u3092\u9ad8\u304f\u4fdd\u3064\uff08\u591a\u8a3a\u7642\u79d1\u53d7\u8a3a\u3092\u63a7\u3048\u308b\u3053\u3068\u3001\u3068\u8a00\u3044\u304b\u3048\u3066\u3082\u3044\u3044\u3060\u308d\u3046\u304b\uff09\u3053\u3068\u306f\u907f\u3051\u3089\u308c\u308b\u5165\u9662\u3001\u5165\u9662\u6570\u5168\u4f53\u3092\u6e1b\u3089\u3059\u3053\u3068\u306b\u3064\u306a\u304c\u308b\u3001\u3068\u8a00\u3048\u3001\u65e5\u672c\u306e\u533b\u7642\u8cbb\u9ad8\u9a30\u306e\u89e3\u6c7a\u7b56\u306e\u4e00\u3064\u3068\u3057\u3066\u5bb6\u5ead\u533b\u7642\u79d1\u306e\u8a2d\u7f6e\u304c\u6709\u529b\u3067\u3042\u308b\u3053\u3068\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u306b\u306a\u308b\u306e\u3067\u306f\u306a\u3044\u3060\u308d\u3046\u304b\uff1f
\n\u3053\u306e\u7814\u7a76\u306e\u9650\u754c\u306f\u81ea\u8cbb\u8a3a\u7642\u3092\u542b\u3093\u3067\u3044\u306a\u3044\u3053\u3068\uff08\u975e\u5e38\u306b\u5c11\u306a\u304f\u306f\u3042\u308b\u304c\uff09\uff0c\u60a3\u8005\u306e\u6559\u80b2\u30ec\u30d9\u30eb\u306a\u3069\u306e\u60c5\u5831\u3092\u52a0\u5473\u3057\u3066\u8abf\u6574\u3057\u3066\u3044\u306a\u3044\u3053\u3068\u3001\u7d50\u679c\u3092\u5bb6\u5ead\u533b\u304b\u3089\u306e\u7d39\u4ecb\u3092\u539f\u5247\u3068\u3059\u308b\u56fd\u306b\u306f\u9069\u7528\u3057\u306b\u304f\u3044\u3053\u3068\u3067\u3042\u308d\u3046\u3002
\n\u00a0
\n\u3010\u958b\u50ac\u65e5\u3011
\n2011\u5e743\u670816\u65e5<\/p>\n","protected":false},"excerpt":{"rendered":"

\u3010\u6587\u732e\u540d\u3011 Shou-Hsia Cheng, et al. : A longitudinal examination of continuity of care and avoidable hospitalization … \u7d9a\u304d\u3092\u8aad\u3080 \u56fd\u6c11\u7686\u4fdd\u967a\u3001\u30d5\u30ea\u30fc\u30a2\u30af\u30bb\u30b9\u3068\u3044\u3046\u533b\u7642\u5236\u5ea6\u4e0b\u306b\u304a\u3044\u3066\u3082\u30b1\u30a2\u306e\u7d99\u7d9a\u6027\u3092\u4fdd\u3064\u3053\u3068\u306f\u300c\u907f\u3051\u3089\u308c\u308b\u300d\u5165\u9662\u3092\u6e1b\u3089\u3059<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[],"class_list":["post-639","post","type-post","status-publish","format-standard","hentry","category-8"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/639","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=639"}],"version-history":[{"count":3,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/639\/revisions"}],"predecessor-version":[{"id":843,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/639\/revisions\/843"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=639"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=639"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=639"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}