{"created":"2024-10-29T00:34:01.345817+00:00","id":2015636,"links":{},"metadata":{"_buckets":{"deposit":"1b18d9f5-5303-489c-93ee-3dad223f2d67"},"_deposit":{"created_by":7,"id":"2015636","owner":"7","owners":[7],"pid":{"revision_id":0,"type":"depid","value":"2015636"},"status":"published"},"_oai":{"id":"oai:ocu-omu.repo.nii.ac.jp:02015636","sets":["1623632832836:1721264204516","1721185054892:1721629302325:1721629647774:1721629855759"]},"author_link":[],"item_1617186331708":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"人口減少社会において存続可能な地域医療に関する一考察 : 北海道夕張市の事例より","subitem_title_language":"ja"},{"subitem_title":"ジンコウ ゲンショウ シャカイ ニオイテ ソンゾク カノウナ チイキ イリョウ ニ カンスル イチコウサツ ホッカイドウ ユウバリシ ノ ジレイ ヨリ","subitem_title_language":"ja-Kana"}]},"item_1617186385884":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"A Study on the Sustainability of Regional Medicine in Population Declining Society : A Case Study of Yubari City, Hokkaido","subitem_alternative_title_language":"en"}]},"item_1617186419668":{"attribute_name":"作成者","attribute_type":"creator","attribute_value_mlt":[{"creatorAffiliations":[{"affiliationNames":[{"affiliationName":"大阪市立大学","affiliationNameLang":"ja"},{"affiliationName":"Osaka City University","affiliationNameLang":"en"}]}],"creatorNames":[{"creatorName":"奥田, 徳子","creatorNameLang":"ja"},{"creatorName":"オクダ, トクコ","creatorNameLang":"ja-Kana"},{"creatorName":"Okuda, Tokuko","creatorNameLang":"en"}]}]},"item_1617186499011":{"attribute_name":"権利情報","attribute_value_mlt":[{"subitem_rights":"クリエイティブ・コモンズ　表示 - 非営利 4.0 国際","subitem_rights_language":"ja","subitem_rights_resource":"https://creativecommons.org/licenses/by-nc/4.0/ "},{"subitem_rights":"Creative Commons Attribution-NonCommercial 4.0 International","subitem_rights_language":"en","subitem_rights_resource":"https://creativecommons.org/licenses/by-nc/4.0/ "},{"subitem_rights":"©Author(s).","subitem_rights_language":"en"}]},"item_1617186609386":{"attribute_name":"主題","attribute_value_mlt":[{"subitem_subject":"人口減少社会","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"存続可能な地域医療","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"孤独死","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"在宅医療","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"ポストアウトリーチ","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"Population Declining Society","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Sustainability of Regional Medicine","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Isolated Death","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Home Care","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Post-Outreach (Successor of Outreach)","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_1617186626617":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"人口減少社会において存続可能な地域医療に必要なものは「孤独死抑制」「医療提供人材の最適配分」「都市機能集約化」ではないか。日本で就労する医療者はどう捉えているのか北海道夕張市における先進事例から課題を抽出し、その対応策について意識調査を分析した。人口減少と高齢化への対策は多種多様な社会問題を含んでいるが、本研究では存続可能な地域医療の在り方に着目し①過去10年間に直面した医療課題とその対策・成果、②今後10年間に解決すべき医療課題、全国的に共有可能な社会問題、③全国共通課題として地域医療が限界を迎えないための方策、を検証した。地域医療の在り方を検証する方法として夕張市における現場実務医療者の問題意識調査を行い、エスノグラフィの手法からホリスティック(全体像)分析し課題を抽出した。第一に「地域医療のアウトリーチには今後大きな変革(ポストアウトリーチ)が必要」、第二に「家が点在化した地域のコミュニティでは孤独死の発生は抑制し得ない」、第三に「財政的・人的縮小に起因する都市機能集約において『存続可能な医療』は、よりミニマムに選択されざるを得ない」との課題が抽出され検証をした結果、「地域医療を守る医療機関には医療者が入れ替わっても維持される『システムの箱』の積み上げが必要」、「孤独死には発生抑制より早期発見の方策」、「人的医療資源は通院困難患者より終末期看取り患者への在宅医療提供に重点を置くべき」、「都市機能集約エリアから外れた集落は徐々に消滅して行く」との結果が得られた。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"In population declining society, what is needed for sustainability of regional medicine is the \"suppression of isolated deaths\", \"optimal allocation of human resources for medical care provision\", and \"concentration of urban functions\". I extracted issues from an advanced case study in Yubari City, Hokkaido, to see how medical professionals working in Japan perceive these issues, and analyzed a survey of attitudes about how to deal with them. Although measures to deal with a population decline and aging include a wide variety of social issues, this study focuses on the state of sustainable regional medicine and examines (1) medical issues faced in the past 10 years, measures taken and results achieved, (2) medical issues to be solved in the next 10 years, social issues that can be shared nationwide, and (3) measures to prevent regional medicine from reaching its limits as a common issue nationwide. As a method of verifying the state of regional medicine, I conducted a survey of the problem consciousness of practicing medical personnel in Yubari City, and extracted issues through holistic analysis using ethnographic methods. $ Firstly, \"the outreach of regional medicine needs a major change (post-outreach) in the future,\" secondly, \"the occurrence of isolated deaths cannot be controlled in communities where abandoned land is increasing and houses are scattered,\" and thirdly, \"in the concentration of urban functions due to financial and human downsizing, sustainable medicine must be selected more minimally. As a result, the following issues were identified and examined: \"Medical institutions that ensure regional medicine need to build up a 'system box' that can be maintained even if medical personnel are replaced\"; \"For isolated deaths, measures should be taken for early detection rather than suppression of the occurrence\"; \"Human medical resources should be focused on providing home medical care for terminal care patients rather than for patients who have difficulty going to hospitals\"; \"The results show that \"settlements outside the urban function concentration area will gradually disappear.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_1617186643794":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"大阪市立大学創造都市研究会","subitem_publisher_language":"ja"}]},"item_1617186819068":{"attribute_name":"identifier_registration","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.24544/ocu.20220527-003","subitem_identifier_reg_type":"JaLC"}]},"item_1617186920753":{"attribute_name":"収録物識別子","attribute_value_mlt":[{"subitem_source_identifier":"2436-6870","subitem_source_identifier_type":"ISSN"}]},"item_1617187056579":{"attribute_name":"bibliographic_information","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2022-05-27","bibliographicIssueDateType":"Issued"},"bibliographicPageEnd":"46","bibliographicPageStart":"18","bibliographicVolumeNumber":"22","bibliographic_titles":[{"bibliographic_title":"創造都市研究 : 大阪市立大学大学院創造都市研究科紀要","bibliographic_titleLang":"ja"},{"bibliographic_title":"Research journal for creative cities","bibliographic_titleLang":"en"}]}]},"item_1617258105262":{"attribute_name":"item_1617258105262","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_1617265215918":{"attribute_name":"出版タイプ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_1617353299429":{"attribute_name":"関連情報","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"AA12147442","subitem_relation_type_select":"NCID"}}]},"item_1722232185104":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2022-05-26"}],"displaytype":"detail","filename":"24366870-22-18.pdf","filesize":[{"value":"1.5 MB"}],"format":"application/pdf","mimetype":"application/pdf","url":{"label":"本文","objectType":"fulltext","url":"https://ocu-omu.repo.nii.ac.jp/record/2015636/files/24366870-22-18.pdf"},"version_id":"77e6c18e-ce7f-482c-a5bd-a3e9d26ce5f5"}]},"item_1722577087681":{"attribute_name":"記事種別等","attribute_value_mlt":[{"subitem_description":"論文","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_1725590125188":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_title":"人口減少社会において存続可能な地域医療に関する一考察 : 北海道夕張市の事例より","item_type_id":"40002","owner":"7","path":["1721629855759","1721264204516"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2022-05-26"},"publish_date":"2022-05-26","publish_status":"0","recid":"2015636","relation_version_is_last":true,"title":["人口減少社会において存続可能な地域医療に関する一考察 : 北海道夕張市の事例より"],"weko_creator_id":"7","weko_shared_id":-1},"updated":"2024-10-29T00:34:19.413615+00:00"}