Aozora

Aozora is the Kitayama, Sanae.

"For local independent administrative institution Prefectural Hospital"

Regional Hospital National Institute of Art, the county is considering, what is it good for the citizens. So, you ask the director of hospital operations.

County, as the aim of Germany law, management of creativity possible, and include a flexible organization, personnel and financial management.

On the other hand, you will hear the concerns of staff and field questions. Example,

1. Officials believe the role of a servant of the prefectural hospital-wide position. What difference has not come out of consciousness in non-civil servant.
2. The salary package of incentives to give, do not pay could be reduced even if other employees working normally.
3. Profitability is more important, could be truncated unprofitable, or will protect the health of the region.
4. Germany legalized it be great if, why, what will the situation be considered acceptable to abort the birth of Nagano Hospital, National Hospital Organization.
5. If the same private and public hospitals, you can maintain the role as a safety net.
6. Germany legalized purposes, and reduce labor costs for personnel management based on the name of health, might be placed outside the framework of local government management capacity by separating from the body. So what can be secured personnel.

First the voices of these questions and concerns, please answer. In addition, based on it, once again, please explain why the laws of Germany as a prefecture.

(Director of hospital operations) to answer in turn.

1, are struggling day and night to support the local medical staff in hospitals and general hospitals in other municipalities. Involved in human health care, government officials, non-civil servant before the day has a strong sense of mission as a healthcare business are working hard for. Not that be can not keep a local medical officials, it is important is to work with high ambitions for patients and communities.

2, salaries of non-civil servant-type local independent administrative corporation, under the operation of labor-related laws as well as private, by a corporation based on the results of the work rules and labor negotiations. And not be unilaterally reduced salaries and wages lowered at this stage in previous cases that have not heard of Germany's law.

3, to avoid disrupting the provision of necessary medical services to local needs as Prefectural Hospital. Rather, we want to consider the institutional capability to maintain and improve health.

4, National Nagano Hospital problems caused by the problem of Germany's law has not recognized. Obstetrician shortage is a national problem.

5, Germany legalized in an attempt to privatize not Prefectural Hospital. The County and 100 percent owned corporation established, which continues to provide essential medical services to the region. Quality of medical services provided by a corporation that has been directed to the corporation and the goals determined by a resolution of the County Council, advance the study do not undermine the role played by the incorporation Prefectural Hospital.

6, one of the purposes of reviewing the management structure is easier to perform than the current manpower. Freed from the bondage of law constants of Germany would become easier to secure timely and adequate resources.

Administrative structure from the council is "the most benefit large local independent administrative institution in a high degree of freedom of management to clarify the role of community health and management responsibilities" of being given the report. Has been studying toward Germany in line with this law.

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Prefectural Hospital management situation, and ask the director of hospital operations.

Medical specialty care and advanced remote areas, local hospitals have been responsible for the medical field is in the red is most unprofitable are financed from the Transfers from local governments from countries including the issuance of tax measures.

Art, from the prefecture's total hospital Transfers from other accounts or how much you. Also, the amount from the tax measures that are delivered to the actual amount is included in the standard financial needs of tax revenues, approximately how much would you pay for the county.

Also, in considering the financial condition of Prefectural Hospital, the county government, know what the breakeven point Prefectural Hospital. The hospital management has many fixed costs, including cost savings and system efficiency is less growth in revenue, while income is greatly affected by changes in the number of patients reaching a breakeven point.

So you are aware of five break-even point of each of the hospitals and clinics to share it, you'll have to improve consultation and management.

(Director of hospital operations) and medical expenses cover the administrative costs and unprofitable, according to earmark funds for expenses associated with the development of facilities principal repayment corporate bonds, fiscal 2007 total of 5.3 billion yen and that 28,740,001 1000 . Of these, as the tax measures that are more than 17 billion yen in grants to local governments.

Compiling monthly financial status, and to provide information to the hospital, but the effort to improve the management from the constraints of local public companies, one unable to deal very freely, the situation is not hard to improve ties it.

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Aware of the break-even point, management can Ataru is the common sense of management. Break-even point shows the relationship between costs and revenues of patients must always look at. Please understand. Suzaka hospital, particularly because of competition from nearby hospitals and are important.

Then, I will, I tried to check the status of five prefectural hospital management.

From the need for comparison with other prefectures, Heisei is the website of the Ministry of Internal Affairs has been based on data from 18 of the year.

I tried it the first financial condition of each hospital.

Click to a larger table

(Light blue) the current account balance ratio is said to be 100% or more preferably, the Kiso and Children's Hospital has more than 100, the 91.6 is lower and Anan.

(Yellow) balance ratio is 95 percent of medical practice is more than desirable, the hospital has more than only 101.4 Kiso, Children's Hospital, Anan Komagane 3 and 6-7 is lower batting average. Komagane in psychiatry, Anan has accounted for half of medical and psychiatric hospital beds in large hospitals and welfare elements of the Children's Hospital, because wealthier Transfers from outside the accounting and other medical practice.

Therefore, the ratio of operating income children against the three Anan Komagane Transfers from other accounts of the hospital (where the green) has been higher, say the size of the costs of the prefecture.

(Pink) staff salary costs, the cost of medical practice revenue and 55 percent are considered desirable not to exceed. However, the psychiatric hospital beds and nursing beds, the Komagane 111.3, and high value of 80.6 Anan, the number of patients in outpatient and hospital doctors per capita is 2.6 Children's Hospital and fewer people, the ratio of labor costs is of course higher. Kiso Salaries of management and are mainly Suzaka beds are generally in the range as appropriate.

(From the bottom of the second stage) bed occupancy rate is 86.9% except for the Kiso, both 6-7 and one percent is a low utilization rate. Only nine private hospital called percent off the brink of bankruptcy and is a major challenge.

Overall, the hospital is also in Suzaka Kiso and exacting medical conditions, Honorary Chairman Ukagaemasu to sound management. Kiso Hospital also has to replace the hospital that there is no other 病院Rashiku Art, shows a presence in the region.

Suzaka hospital bed occupancy rate of 79.8 percent is lower, so that the cover is slightly shorter than the other in the average length of stay. However, even in conflict with the neighboring hospital, must be attached to clarify the significance of being public.

Hospital Komagane Iezu current account ratio is bad, and competitive. However, the number of patients per day as high as 27.3 persons per doctor who will be the size of the burden of medical care.

Anan hospital if the situation is hardly good management, and hospital beds in general, the number of patient visits per person per day and 23.5 doctors who, significantly more than in other prefectural hospitals, regional base also holds the role of a hospital.

Children's Hospital, the nature of welfare is strong, the current account balance ratio is high, not Iemasu and business conditions compared favorably with other County Children's Hospital.

Then, the entire hospital accounting, the other 4 I like the size of population compared to the prefecture.

Click on the larger graph

Explore the safety indicators, the equity ratio, long-term capital-to-assets ratio, liquidity ratio and, indicators as to the profitability of the bar, the ratio of current account balance ratio when viewed from medical practice, the constitution, but rather in debt, Nagano Prefecture hospital accounting seems to be generally sound financial condition.

Number of employees per 100 beds on the floor (blue bars) is 91.2 people in Nagano Prefecture, Japan and other than one percent fewer people are in luck. Number of physicians per person per day for patients (green and red bars) compared to many other cities and counties the cost of staff salaries for one-to-earnings that medical practice (brown stick) is 68.3, the high proportion of labor costs compared to other cities and counties and can not say.

Transfers from other accounting versus current account balance ratio (gray bars) is also special and Nagano can not say more.

Thus, the management of hospitals in Nagano Prefecture, not comparable with other prefectures, or you can say that's not luck.

So, you ask the director of hospital operations.

It was my amateur analysis and management, If you have any awareness at variance with director, pointed out please. Art, even though the scene seems that the management is hard work, and yet, the significance of what law is and where in Germany.

(Director of the hospital business) a summary of business conditions in Morai Prefectural Hospital, thank you.

Social environment and historical background of each hospital, staff configuration, such as crowding of the general accounting standards can only discuss the analysis of a single year is difficult and late husband.

If we have pointed out, a Children's Hospital is a pediatric medical institutions to provide advanced medical care, welfare point out that nature is just not strong.

Nagano prefectural hospital management and as pointed out there is comparable to other prefectures, like the length of each hospital center for people trying to improve management.

However, significant constraints on the current system personnel, doctors and nurses can not be ensured, and because of that single year accounting system, reduce the freedom of management, business conditions are deteriorating.

To respond quickly to changes in medical treatment fees and medical needs, aims to reduce the loss of income and opportunities and secure, to make better management is essential to ensure implementation of human resources and flexibility in the budget accounting system, so Germany legalized is considered extremely effective.

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To ask the governor, I think there is dissatisfaction in the field and not just presume that the hospital reform of laws and not Germany. In advance of predictable laws and Germany, will become a way to deny that luck. I need to be able to form the intention of the site, I will invite a calamity remains.

(Murai) The Council is the administrative organization, conducted a survey of prefectural hospital, to solve the problems that come from each hospital, considering that capped the most appropriate management style or how. In listening to various hospital officials, the only constraint is also an institutional efforts can not be resolved. The hospital business office has been instructed to proceed carefully study better while listening to voices of hospital staff.

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I'll come back to the governor.

Law proceeded to lead the prefectures of Japan and Germany are demanding financial everywhere. In Nagano Prefecture, the intention of the laws of Germany if the fiscal situation of the Province from 53 if it's just that you want to reduce the amount of Transfers from 100 million yen, or working in a flexible wage system is a double-edged blade , will be able to work freely and enhance reduction in salary, employees may fear here.

Also possible that the creative management and financial management, and to allow costs to the value of free services for residents is also a double-edged blade. After all, public hospitals are to be installed in difficult areas and play a role in the management field. Of truncating the tail wagging the dog is unprofitable.

No other comparable county and the hospital management of Nagano Prefecture, a welfare role, carrying on a mission to evaluate the role that regional, rather than just another legalized proceed immediately with Germany, residents To provide good health care is what to do, I would like to deepen it from there. I understand your question ends with the findings of the governor one last time.

(Murai) Prefectural Hospital that is very thought played a role. 申Shi health is a top priority since taking office and the Prefectural Government. Prefectural Hospital is reviewing the management structure shall be considered to continue to provide better health care for residents in the future.

Thus, it is a very big challenge to make efforts to ensure the medical staff including doctors. In applying the current part of the Local Public Enterprise Act is limited to a very significant constraint. Of a local independent administrative corporation, the spread of management flexibility than in its current form, it feels much more appropriate.

Studying while listening to the opinions of the hospital business office staff around the hospital today. Given the difficult circumstances surrounding the hospital today, there is a need to proceed in a hurry.

County Council Relay recording "Rep. Kitayama, Sanae" You can see the video.

entry: on 12.6.2008 at 1:12 am / Blog: County Council report.
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