{"created":"2023-06-19T11:24:33.372287+00:00","id":5290,"links":{},"metadata":{"_buckets":{"deposit":"a8e5907b-ef12-4aae-801d-72b3239c8eaa"},"_deposit":{"created_by":1,"id":"5290","owners":[1],"pid":{"revision_id":0,"type":"depid","value":"5290"},"status":"published"},"_oai":{"id":"oai:asahikawa-med.repo.nii.ac.jp:00005290","sets":["7","7:23"]},"author_link":["16570","16571","16568","16569","16567","16572"],"item_5_biblio_info_21":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2015-05-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"5","bibliographicPageEnd":"6","bibliographicPageStart":"1","bibliographicVolumeNumber":"62","bibliographic_titles":[{"bibliographic_title":"厚生の指標"}]}]},"item_5_description_33":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"目的 北海道内の居住地域から,脳梗塞アルテプラーゼ静注療法の実施できる脳卒中急性期医療拠点病院への自動車アクセス時間について地理情報システム(GIS)ソフトウエアを用いて推定し,またアクセス時間を短縮することで改善するための拠点病院配置案を示すことを目的とした。方法 北海道医療計画に掲載されている61医療機関を脳卒中急性期医療拠点病院とし,平成22年国勢調査における町丁字別人口に1人以上の居住者が存在する地区ごとに,直近の拠点病院への自動車アクセス時間を推定した。二次医療圏・市町村ごとのアクセス時間は町丁字別人口居住者数の重み付けをした平均値として算出した。またアクセス時間を改善するための拠点病院配置案については,二次医療圏ごとにアクセス時間上位の二次医療圏へ,7医療機関を新たに割り当てたアクセス時間改善案の検討も行った。結果 61拠点病院へのアクセス時間について,平均60分以上となる二次医療圏が6医療圏存在し,うち90分以上は5医療圏であった。アクセス時間を改善するための拠点病院追加案については,(1)二次医療圏でアクセス時間が平均60分以上であり,医療圏内に拠点病院が設定されていない6医療圏,(2)アクセス時間60分以上に該当する人数が,約7万4千人と医療圏では2番目に多い1医療圏に1拠点病院を追加したと仮定した。以上,計68拠点病院とした場合の二次医療圏ごとのアクセス時間を計算すると,平均60分以上は1医療圏のみとなった。結論 本研究では,GISソフトウエアを用いて,特に二次医療圏ごとの拠点病院への平均アクセス時間を示した上で,北海道の現状を考えた脳卒中急性期医療拠点病院の例を示した。脳梗塞急性期治療については,二次医療圏や自治体ごとのアクセス状況を検討し,地域の現状を考えて改善案を考えていく必要があると考える。","subitem_description_type":"Abstract"}]},"item_5_description_36":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"雑誌掲載版","subitem_description_type":"Other"}]},"item_5_description_37":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"text","subitem_description_type":"Other"}]},"item_5_description_41":{"attribute_name":"フォーマット","attribute_value_mlt":[{"subitem_description":"application/pdf","subitem_description_type":"Other"}]},"item_5_relation_27":{"attribute_name":"医中誌ID","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"2015283969","subitem_relation_type_select":"ICHUSHI"}}]},"item_5_source_id_22":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0452-6104","subitem_source_identifier_type":"ISSN"}]},"item_5_text_44":{"attribute_name":"ID(XooNIps)","attribute_value_mlt":[{"subitem_text_value":"2015283969"}]},"item_5_text_54":{"attribute_name":"閲覧数(XooNIps)","attribute_value_mlt":[{"subitem_text_value":"539"}]},"item_5_text_55":{"attribute_name":"ダウンロード数(XooNIps)","attribute_value_mlt":[{"subitem_text_value":"596"}]},"item_5_text_7":{"attribute_name":"著者 ローマ字","attribute_value_mlt":[{"subitem_text_value":"Saijo, Yasuaki"},{"subitem_text_value":"Nakagi, Yoshihiko"},{"subitem_text_value":"Kawanishi, Yasuyuki"},{"subitem_text_value":"Yoshioka, Eiji"},{"subitem_text_value":"Ito, Toshihiro"},{"subitem_text_value":"Yoshida, Takahiko"}]},"item_5_version_type_38":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"西條, 泰明"},{"creatorName":"サイジョウ, ヤスアキ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"16567","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"中木, 良彦"},{"creatorName":"ナカギ, ヨシヒコ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"16568","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"川西, 康之"},{"creatorName":"カワニシ, 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MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"6259.pdf","url":"https://asahikawa-med.repo.nii.ac.jp/record/5290/files/6259.pdf"},"version_id":"74a41e0a-5780-4b2c-8e6b-30af84c2ead4"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"脳梗塞","subitem_subject_scheme":"Other"},{"subitem_subject":"遺伝子組み換え組織プラスミノゲンアクチベーター（rt-PA,アルテプラーゼ）","subitem_subject_scheme":"Other"},{"subitem_subject":"拠点病院","subitem_subject_scheme":"Other"},{"subitem_subject":"地理情報システム（Geographic Information System：GIS)","subitem_subject_scheme":"Other"},{"subitem_subject":"アクセス時間","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal 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