病床機能報告を用いた医療提供体制における地域性の検討

京都府立医科大学大学院生命基礎数理学京都府立医科大学大学院地域保健医療福祉行政システム学奈良県立医科大学地域医療学講座和歌山大学観光学部京都府立大学大学院生命環境科学研究科京都先端科学大学健康医療学部地域医療構想は、医療計画の一部として持続可能な社会保障制度の確立に重要な役割を担っている。現在、超高齢社会にも耐えうる医療提供体制の構築に向けて、地域の実情に合わせた病床機能分化の定量的な基準が検討されている。本報告は、病床機能報告データを用いて、全国の各都道府県および2 次医療圏の病床機能区分割合を算出し、空間パターン解析を実施した。その結果、都道府県別は、高度急性期と急性期の病床割合が、東日本において高い値の集積（ホットスポット）、西日本において低い値の集積（コールドスポット）が広範囲で統計的有意に認められた。一方で、2次医療圏別では広域なスポットの特徴はみられなかった。本結果は、病床機能区分割合の地域性があることを示し、地域医療提供体制の構築に有用な情報である

病床機能報告における入退棟経路による病棟機能分類の検討

京都府立医科大学大学院生命基礎数理学京都府立大学大学院生命環境科学研究科和歌山大学観光学部京都先端科学大学健康医療学部病床機能別病床数の検討による適切な医療提供体制の構築は、超高齢社会に対応する持続可能な社会保障制度の確立に重要である。本研究は、医療機関の入退棟経路の特徴と機能区分を明らかにすることを目的とした。厚生労働省が公表している2018 年6月の1か月分の病床機能報告を用いて、主に成人の医療を実施する全国の9,627病院26,366病棟を対象に、入棟前・退棟先の場所別の患者構成割合による主成分分析を実施した。その結果、入退棟経路による上位4主成分を抽出（累積寄与率61.3%）し、それぞれの特徴的な入退棟経路と病床機能区分との傾向を明らかにした。これらの評価指標により、病床機能報告における入退棟経路の患者構成割合から病棟の持つ医療機能を推測する可能性が示唆された。本分析結果は、地域医療構想実現に向けた有用な基盤情報となり得る

Estimated 24-hour urinary sodium excretion and sodium-to-potassium ratio among Japanese elementary school teachers and school lunch cooks

Background:Dietary salt intake is largely responsible for increase in blood pressure that is commonly seen with aging. In our previous study carried out in 2015, we calculated the 24-hour urinary sodium excretion and sodium-to-potassium (Na/K) ratio among elementary school children. In the present study, we aimed to examine the same items among the school children’s teachers and lunch cooks.Methods:Of 153 recruited participants, urine samples were collected from 129 subjects (84.3%), and 124 subjects (81.0%; 37 male teachers, 65 female teachers, and 22 female cooks) whose dietary habits were confirmed were included in the final study analysis.Results: The median estimated 24-hour urinary salt excretion (g/day) was 8.2 in male teachers, 7.4 in female teachers, and 8.9 in cooks. The median urinary Na/K ratio (mEq/mEq) was 4.1 in male teachers, 3.6 in female teachers, and 4.0 in cooks. In both male and female teachers and cooks, no association was found between urinary salt excretion or urinary Na/K ratio and an awareness of the need to restrict salt intake. The proportion of subjects with both a urinary salt excretion and Na/K ratio above the median was high in male teachers and cooks, whereas the proportion of subjects who scored below the median in both tests was high in female teachers.Conclusion:It should be considered that elementary school teachers and cooks who have been provided with the results of their own salt excretion could realize the importance of reducing salt consumption from early childhood and the continuous salt intake reduction education for children

Characteristic dietary habits associated with high values of estimated 24-hours urinary sodium excretion and sodium-to-potassium ratio assessed by age group among the residents of a rural town in Japan

Excess salt intake causes hypertension and cardiovascular disease (CVD). We examined estimated 24-h urinary sodium (Na) excretion and sodium-to-potassium (Na/K) ratio and analyzed the association between estimated 24-h urinary salt excretion (urinary salt excretion) and dietary habits by age group to develop effective public health programs to promote salt reduction. A total of 4,051 subjects aged 30–74 years old received information during periodic health checkups. In the analysis, 1,202 subjects without hypertension whose urine samples and dietary habits were confirmed (29.7%; 483 men and 719 women) were included. The median urinary salt excretion was 9.1 g/day in men and 8.6 g/day in women. Daily intake of soups in men aged <50 years old and daily intake of beans, soups, or pickles in women aged ≥70 years old were associated with high values of urinary salt excretion (p = .03, p < .01, p = .01, and p = .02, respectively). The median urinary Na/K ratio (mEq/mEq) was 4.4 in both men and women. Daily intake of vegetables in men aged <50 years old and more than 3 days/week intake of fruit in women aged 50–59 and 60–69 years old were associated with lower values of urinary Na/K ratio (p = .03, p < .01, and p < .01, respectively). These findings revealed that dietary salt reduction should be promoted according to age group with regard to differences in dietary habits associated with high values of estimated 24-h urinary Na excretion and urinary Na/K ratio

Estimation of salt intake and sodium-to-potassium ratios assessed by urinary excretion among Japanese elementary school children

Dietary salt intake is largely responsible for the increase in blood pressure with age. It is important to start effective prevention approaches during childhood. In this study, we estimated salt intake and sodium-to-potassium (Na/K) ratios assessed by urinary excretion among elementary school children in Kyoto, Japan. A total of 331 subjects aged 9–11 years participated in school checkups in April 2015. Urinary concentrations of sodium, potassium, and creatinine were measured in first morning urine samples. The subjects’ dietary habits were confirmed by questionnaires completed by their parents. The median estimated urinary sodium excretion was 129.0 mmol/day (5.7g/day of salt). In 30.2% of the subjects, their estimated salt intake exceeded their age-specific dietary goal for salt intake recommended by the Dietary Reference Intakes for Japanese 2015. Multivariate linear regression model analysis after adjustment for age revealed a significant positive correlation between seaweeds or fish paste products consumption and the estimated salt intake (p = 0.02 and 0.02, respectively). The median urinary Na/K ratio (mEq/mEq) was 4.5. Multivariate linear regression model analysis revealed a significant negative correlation between fruit consumption and urinary Na/K ratio (p = 0.04). These results suggest that the high sodium intake and the high Na/K ratios occur among Japanese elementary school children, and that the urinary Na/K ratio in children may be reduced by the daily consumption of fruit

病床機能報告における入退棟経路による病棟機能分類の検討

京都府立医科大学大学院生命基礎数理学京都府立大学大学院生命環境科学研究科和歌山大学観光学部京都先端科学大学健康医療学部病床機能別病床数の検討による適切な医療提供体制の構築は、超高齢社会に対応する持続可能な社会保障制度の確立に重要である。本研究は、医療機関の入退棟経路の特徴と機能区分を明らかにすることを目的とした。厚生労働省が公表している2018 年6月の1か月分の病床機能報告を用いて、主に成人の医療を実施する全国の9,627病院26,366病棟を対象に、入棟前・退棟先の場所別の患者構成割合による主成分分析を実施した。その結果、入退棟経路による上位4主成分を抽出（累積寄与率61.3%）し、それぞれの特徴的な入退棟経路と病床機能区分との傾向を明らかにした。これらの評価指標により、病床機能報告における入退棟経路の患者構成割合から病棟の持つ医療機能を推測する可能性が示唆された。本分析結果は、地域医療構想実現に向けた有用な基盤情報となり得る