働き方改革を支える病児保育

ୈճஉঁڞಉࢀըϑΥʔϥϜߨԋ ʮಇ͖ํվֵΛࢧ͑Δපࣇอҭʯ $**OD୅දऔక໾౦ژେֶ࢈්ਓՊڭࣨ Ԃాਖ਼थ Ἒ৓ݝҩࢣձ

ຊ೔ͷεϥΠυ͸ຕͱଟ͍ͨΊ ൈਮͯ͠ࣄલ഑෍ࢿྉͱ͠·ͨ͠ɻ 23ίʔυ ͢΂ͯͷࢿྉ͸ͪ͜Β͔ΒӾཡͰ͖·͢ IUUQTCJUMZ//V0$:

w ໌೔͔Βಇ͖ํվֵΛ࣮ߦ͢Δ ɹɹɹ͋ͳͨͷ৬৔ͷ࢒ۀΛݮΒ͢ͷํ๏ ຊ೔ͷΰʔϧ w ಇ͖ํվֵʹपғΛר͖ࠐΉ w ಇ͖ํվֵͷඞཁੑͱํ๏Λೝࣝ͢Δ

ࣗݾ঺հ ୈ̍ষɹಇ͖ํվֵɹ෼ʴ෼ ୈ̎ষɹঁੑҩࢣͷಇ͖ํͱӃ಺อҭɹ෼ʴ෼ ୈ̏ষɹපࣇอҭͱҩࢣͷىۀɹ෼ʴ෼ ࣭ٙԠ౴ɹ෼ ΞδΣϯμ

وॏͳػձΛຊ౰ʹ͋Γ͕ͱ͏͍͟͝·͢ɻ ஛த৻ઌੜ Ԃాਖ਼थ

࢈්ਓՊҩ ౦ ژ େ ֶ େ ֶ Ӄ ެ ऺ
Ӵ ੜ ֶ ࢈ ් ਓ Պ ֶ ձ ҩ ྍ վ ֵ ҕ һ ձ ઐ ໳ ҩ ੍ ౓ ҕ һ ձ පࣇอҭͷઐ໳Ո ࢈්ਓՊҩ͔Βපࣇอҭͷઐ໳Ո΁

࣌ؒ֎࿑ಇΛ·ͣ͸͜ͷϨϕϧ·ͰԼ͛Δʂ ʢ࣮ྫΛݩʹ࡞੒ʣ ա࿑ࢮϥΠϯ ΩʔʹͳΔ਺ࣈ

࣌ؒ ա࿑ࢮϥΠϯ ΩʔʹͳΔ਺ࣈ

ᶃॏ఺Խʢू໿Խʣ ᶄมܗ࿑ಇ੍࣌ؒ ᶅ୹࣌ؒۈ຿ऀͷ׆༂ ࣌ؒ֎࿑ಇΛݮΒͨ͢Ίʹඞཁͳ͜ͱʢཧ࿦ฤʣ

ϚΫϩฤ ްੜ࿑ಇলҩࢣͷಇ͖ํվֵʹؔ͢Δݕ౼ձΛத৺ʹ

ಇ͖ํվֵʢҩࢣ൛ʣ w೥͔Βҩࢣʹ͸దԠ w೥࣌ؒ ݄࣌ؒ Ҏ಺ͷ࣌ؒ֎࿑ಇ͕໨ඪ wಛఆͷҩࢣʹ͸೥࣌ؒ ݄࣌ؒ ·Ͱͷ ࣌ؒ֎࿑ಇΛೝΊΔ

ҩࢣͷۈ຿࣌ؒ ްੜ࿑ಇলɹୈճɹҩࢣͷಇ͖ํվֵʹؔ͢Δݕ౼ձɹࢿྉΑΓ Ҏ্ͷۈ຿ҩ͸ա࿑ࢮϥΠϯΛ௒͑ͯಇ͍͍ͯΔ

एखҩࢣͷಇ͖ํ ްੜ࿑ಇলɹୈճɹҩࢣͷಇ͖ํվֵʹؔ͢Δݕ౼ձɹࢿྉΑΓ ଔޙ̏ ʙ̑ ೥໨ͷපӃۈ຿ҩͷिۈ຿࣌ؒͷ۠෼ผׂ߹˞̎ ˞̍ ۈ຿࣌ؒʹ͍ͭͯ͸ɺʮපӃۈ຿ҩͷۈ຿࣮ଶʹؔ͢Δݚڀʯʢฏ੒೥౓ްੜ࿑ಇߦ੓ਪਐௐࠪࣄۀඅʮපӃۈ຿ҩͷۈ຿࣮ଶʹؔ͢Δௐࠪݚڀʯݚڀ൝ʣͷूܭ݁Ռ͔Βɺʮ਍ྍ ֎࣌ؒʯʢڭҭɺݚڀɺֶशɺݚम౳ʣʹ͓͚Δ্࢘౳͔Βͷࢦࣔʢ໧ࣔతͳࢦࣔΛؚΉɻʣ͕ͳ͍࣌ؒʢௐࠪථʹʮࢦࣔແʯΛهೖʣ͕ ˋͰ͋Δ͜ͱΛ౿·͑ɺʮҩࢣͷۈ຿࣮ଶٴͼ ಇ͖ํͷҙ޲౳ʹؔ͢Δௐࠪʯʹ͓͚Δݸථͷ਍ྍ֎࣌ؒΑΓ࡟ݮͨ͠ɻ
˞̎ ݱࡏͷઐ໳ҩ੍౓ʹ͓͚Δઐ߈ҩͷظؒ͸ྟচݚमऴྃޙ̏೥Ҏ্ͱ͞Ε͍ͯΔɻ 6.9% 12.7% 5.2% 1.7% 4.6% 0.0% 5.0% 10.0% 15.0% ि40࣌ؒະຬ ि40Ŗ50࣌ؒ ि50Ŗ60࣌ؒ ि60Ŗ70࣌ؒ ि70Ŗ80࣌ؒ ि80Ŗ90࣌ؒ ि90Ŗ100࣌ؒ ि100࣌ؒҎ্ 5 8.5% 13.9% 24.0% 19.6% 16.0% 10.9% 3.4% 3.8% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% ि40࣌ؒະຬ ि40ʵ50࣌ؒ ि50ʵ60࣌ؒ ि60ʵ70࣌ؒ ि70ʵ80࣌ؒ ि80ʵ90࣌ؒ ि90ʵ100࣌ؒि100࣌ؒҎ্ ˞ʮ ࢦࣔͷͳ͍࣌ؒʯ ͷ࡟ݮޙ

େֶපӃͷҩࢣͷಇ͖ํ ࣌ؒʙ ʹ೔ಇ͘ͱͯ࣌ؒ͠EBZͷ࣌ؒ֎ʢա࿑ࢮϥΠϯͷ̎ഒʣ

ୈճ࢈්ਓՊಈ޲ҙࣝௐ͔ࠪΒΘ͔ͬͨ͜ͱ ୈճ࢈්ਓՊಈ޲ҙࣝɾλεΫγϑτௐࠪ ೥݄࣮ࢪ ಇ͍ͯ΋ ධՁ͞Ε͍ͯͳ͍

࿑ಇ҆શӴੜ๏ ग़ୀۈσʔλͷه࿥͕ٛ຿ ೥݄ʙ

࿑ಇ҆શӴੜ๏ ϙΠϯτ ࿑ಇ࣌ؒͷঢ়گͷ೺ѲΛ͢Δ΂͖ʮର৅ऀʯ w ձࣾͰಇ͘͢΂ͯͷ࿑ಇऀʢ໾һআ͘ʣ w ࿑ಇج४๏Ͱ͸ɺ؅ཧ؂ಜऀ΍ࣄۀ৔֎ͷΈͳ͕͠ద༻͞ΕΔ ैۀһ͸আ͔Ε͍ͯͨ ʮ࿑ಇ࣌ؒͷzঢ়گzͷ೺Ѳʯ͕໨త w
࿑ಇج४๏Λ९क͢Δ໨తͱ͸ҟͳΔ w ๏ఆ࿑ಇ࣌ؒ΍ׂ૿௞ۚͷࢧ෷͍ͳͲ

ಇ͖ํվֵ࣮ݱ΁ͷ՝୊ ू໿Խ͕ग़དྷ͍ͯͳ͍

7PMVNFPVUDPNFSFMBUJPOTIJQ Birkmeyer JD et al.Surgeon volume and operative mortality in
the United States. N Engl J Med. 2003,27;349(22):2117-27.

ಇ͖ํվֵ࣮ݱ΁ͷ՝୊ ίϝσΟΧϧ͕গͳ͍ λεΫγϑτ͢Δઌ΋๩ͯ͘͠ɺγϑτग़དྷͳ͍

ܦࡁࡒ੓ࢾ໰ձٞ ׭ຽͰ̍̏ສපচ࡟ݮΛ ҩྍඅ཈੍Ͱຽؒٞһఏݴ w ೥ʹඞཁͱͳΔපচ਺Λࣔ͢ ʮ஍Ҭҩྍߏ૝ʯΛࡦఆ ˞೥ɿஂմͷੈ୅͕ࡀҎ্΁

ϛΫϩฤ Θͨࣗ͠਎ͷ͓࿩ͱ࢈්ਓՊ

݄ Ր ਫ ໦ ۚ ౔ ೔ ࣌ؒ֎࿑ಇ ࣌ؒि ݄
࣌ؒ େֶि̐ʢ໷ۈ݄ճʣ ʴ֎ۈि̍ʢ࣌ؒʣ ֎ۈ ֎ۈ ֎ۈ େֶපӃ ࣌ ࣌ ࣌ ࣌ ࣌ ࣮ࡍͷ࿑ಇ؀ڥᶃ

िʢ໷ۈ݄ճʣ ʴΦϯίʔϧ݄ճ ݄ Ր ਫ ໦ ۚ ౔ ೔ ࣌ؒ֎࿑ಇ
࣌ؒि ݄ ࣌ؒ ৗۈਓ ஍Ҭप࢈ظ ηϯλʔ" ࣌ ࣌ ࣌ ࣌ ࣌ ࣮ࡍͷ࿑ಇ؀ڥᶄ

࣌ؒ ݄ ࣌ؒ ৗۈਓ ʴେֶ֎ۈि̎ ஍Ҭप࢈ظ ηϯλʔ# ࣌ ࣌ ࣌ ࣌ ࣌ ࣮ࡍͷ࿑ಇ؀ڥᶅ

࣌ؒ ݄ ࣌ؒ ৗۈਓ ʴେֶ֎ۈि̎ ஍Ҭप࢈ظ ηϯλʔ# ࣌ ࣌ ࣌ ࣌ ࣌ ࣮ࡍͷ࿑ಇ؀ڥᶅ ࣋ଓՄೳͰͳ͍

࢈්ਓՊͷಛघੑ

ɾएख࢈්ਓՊҩͷ໿ׂ͕ঁੑҩࢣ ɾ࢈Պͷ໷ۈ͸z࢈්ਓՊҩ͚ͩz͕Մೳ ΑΓྑ͍ಇ͖ํվֵ͕ٻΊΒΕΔʂ

ग़య ೔ຊ࢈Պ්ਓՊֶձɹ ೔ຊ࢈්ਓՊҩձ ʮΘ͕ࠃͷ࢈්ਓՊҩྍ ࠶ݐͷͨΊͷۓٸఏݴʯ ฏ੒26೥12݄13೔ ೔ຊ࢈Պ්ਓՊֶձੑผ೥ྸผձһ਺ʢ೥݄ʣ

ϐϯν͸ νϟϯεʂ

ग़య ೔ܦϝσΟΧϧసࡌɹ ʢ2019/2/4ʣ

࢈Պ්ਓՊֶձ͸ ઌਐతʹٞ࿦ɺఏݴ͍ͯ͠Δ

࢈්ਓՊͷݱঢ়

ҩࢣ਺ͷਪҠ

ত࿨57೥/ฏ੒9೥ ֳܾٞఆ ฏ੒18೥ ʮ৽ҩࢣ֬อ ɹ૯߹ରࡦʯ ฏ੒20೥ ʮܦࡁࡒ੓վֵ ͷجຊํ਑ 2008ʯ ʢ૿һظؒʣ
ฏ੒31೥౓·Ͱ (ฏ੒27೥౓·Ͱ) ஍Ҭ࿮ɿ564ਓ ݚڀҩ࿮ɿ40ਓ ஍Ҭ࿮ 1305໊ (14.4%) 62େֶ ஍Ҭ࿮ 1452໊ (15.7%) ฏ੒28೥౓ҩֶ෦ೖֶఆһ૿ʹ͍ͭͯh2ps://www.google.co.jp/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&ved=0ahUKEwjZw8GFxIPPAhWDopQKHYD7CYsQFggmMAI&url=h2p://www.mext.go.jp/b_menu/houdou/27/10/ __icsFiles/aﬁeldﬁle/2015/10/23/1363060_4_1.pdf&usg=AFQjCNFoYH3OuEBbjzIdKh2GJMmdS1gl1Q&bvm=bv.132479545,d.dGo ΑΓ࡞੒ ೥ʢ೥લʣ ҩࢣࠃՈࢼݧ߹֨ऀ ਓ ҩֶ෦ೖֶఆһ਺ͷਪҠ

) ) ) ) ) )
) ) ࢈්ਓՊઐ߈ҩొ࿥ऀ਺ ઐ߈ҩͱͳΔҩࢣશମʹ͓͚Δ ࢈්ਓՊઐ߈ҩͷׂ߹ ௗऔେֶ খদ޺জઌੜ ஜ೾େֶ ࡉ઒ٛ඙ઌੜ ఏڙσʔλ͔Β࡞੒ ࢈්ਓՊઐ߈ҩ͸ճ෮܏޲ एखҕһൃ଍ ʢˋʣ ʢਓʣ

@தҪ ষਓઌੜʢ೔ຊҩՊେֶʣ ʢҰ෦վมʣ ࢪઃ਺ ෼ṯࢪઃ͸ ݮগ

࣌ؒ֎࿑ಇͰ ࠷΋ΠϯύΫτ͕͋Δͷ͸ l໷ۈͷճ਺z ʮ౰௚ʯͰ͸ͳ͘ʮ໷ۈʯͰ͢ʂ

౰௚ͱ͍͏ͷ͸ ʮ౰൪ΛܾΊͯۈ຿͢Δ͜ͱʯ ͱ͍͏ͷ͕ຊདྷͷҙຯɻ ۀ຿಺༰΍ಇ࣌ؒ͘ଳΛࢦ͢΋ͷͰ͸ͳ͘ɺ ೔௚ɺ॓௚ɺͲͪΒ΋౰௚ͱ͍͑Δɻ ࢀߟ ɹ௨ৗۈ຿ɿ೔ۈɺ໷ۈʢ४໷ۈɾਂ໷ۈʣ ɹ౰௚ɹɹɿ೔௚ɺ॓௚ ࢀߟɿʮ౰௚ʯͱ͍͏ݴ༿ͷ֬ೝ

॓௚Ͱ͋ͬͯ΋ɺिճ্͕ݶͰ͢ʂ ਍ྍߦҝΛߦΘͳ͍ٳ೔ٴͼ໷ؒۈ຿͕ ࿑ಇج४๏ୈ৚߸ͷ౰௚ʢ॓೔௚ʣۈ຿ ۩ମతʹ͸ɾɾɾ ɾපࣨͷఆ࣌८ճ ɾগ਺ͷױऀͷݕԹɺཁ஫ҙױऀͷఆ࣌ݕ຺ͳͲ ʮ॓௚ʯͷఆٛ

໷ۈPS॓௚ ʮ౰௚ʯͱ͍͏ݴ༿ͷ֬ೝ େ੾ͳͷ͸ ͋ͳ͕͍ͨͭ΋ߦͳ͍ͬͯΔʮ౰௚ʯ͸

ਖ਼֬ʹ͸ ʮ໷ۈʯͰ͋Γ ͢΂ͯͷ͕࣌ؒʢ࣌ؒ֎ʣ࿑ಇ࣌ؒʹʂʂ զʑ࢈්ਓՊҩ͕΍͍ͬͯΔͷ͸ʮ॓௚ʯͰ͸ͳ͘ ॳ࢈්ͷฏۉ෼ṯ࣌ؒ͸࣌ؒͰ͋Γ೔ۈଳͰ͸ऴྃ͠ͳ͍ͨΊ ෼ṯΛ΍͍ͬͯͨΒ͢΂ͯz໷ۈzͱߟ͑ͯɺ0,ɻ

࢈්ਓՊҩͷʮ॓௚ʯճ਺͸ଞՊΑΓ΋ଟ͍ @தҪ ষਓઌੜʢ೔ຊҩՊେֶʣ ʢҰ෦վมʣ

݄ Ր ਫ ໦ ۚ ౔ ೔ िʢ໷ۈ݄ճʣ ʴΦϯίʔϧ݄ճ ৗۈਓ
࣌ ࣌ ࣌ ࣌ ࣌ ஍Ҭप࢈ظ ηϯλʔ" ࣌ؒ֎࿑ಇ ࣌ؒि ݄ ࣌ؒ ʢ࠶ܝʣ஍Ҭप࢈ظηϯλʔ"Ͱͷۈ຿

݄ Ր ਫ ໦ ۚ ౔ ೔ िʢ໷ۈ݄ճʣ ʴΦϯίʔϧ݄ճ ৗۈʁਓ
࣌ؒ֎࿑ಇ ࣌ؒ ݄ ࣌ؒ ஍Ҭप࢈ظ ηϯλʔ" ࣌ ࣌ ࣌ ࣌ ࣌ ໷ۈΛिճ΁ Կਓମ੍ͳΒ ࣮ݱՄೳʁ

ਓ໷ۈ ମ੍ͷ৔߹ ̎ਓ໷ۈମ੍ͷ৔߹໊ @தҪ ষਓઌੜʢ೔ຊҩՊେֶʣ ʢҰ෦վมʣ

൒਺Ҏ্ͷࢪઃ͕े෼ͳৗۈҩࢣΛ֬อͰ͖͍ͯͳ͍ @தҪ ষਓઌੜʢ೔ຊҩՊେֶʣ ʢҰ෦վมʣ

९๏ϥΠϯୡ੒͸ະͩݟ͑ͣ ॓௚ͷճ਺͸΄ͱΜͲݮΒ͍ͤͯͳ͍ @தҪ ষਓઌੜʢ೔ຊҩՊେֶʣ ʢҰ෦վมʣ

࣌ؒ֎࿑ಇΛݮΒ͢ʹ͸ ʮॏ఺Խʯ͕ඞཁʂʂ େֶ͔Β໷ۈͷԠԉΛͯ͠΋Βͬͯ΋ ࠜຊతͳղܾʹͳΒͳ͍ʂʂ ʢେֶۈ຿ͷઌੜ͕݄ճҎԼͳΒྑ͍͕௨ৗ͋Γಘͳ͍ʂʣ

*NQBDUPGIPTQJUBMDPOTPMJEBUJPOGPSTVSHFSZ Number of cases Quality For young surgeon Surgical opportunity
Experience; various cases Burden (per one surgeon) Training environment for Professional medical staff Flexibility for absentee maternity / childcare family caregiver / sickness Impact of hospital consolidation for surgery Small team Big team @ཱੴ ࣮ઌੜʢ੟ྴ඿দපӃ ৺ଁ݂؅֎Պʣ

มܗ࿑ಇ੍࣌ؒ

࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ൟ๩೔ มܗ࿑ಇ࣌ؒੑʹΑͬͯ ࿑ಇ࣌ؒΛൟ๩೔ʹ ഑෼Ͱ͖Δ
݄ Ր ਫ ໦ ۚ มܗ࿑ಇ੍࣌ؒ

࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ൟ๩೔ มܗ࿑ಇ࣌ؒੑʹΑͬͯ ࿑ಇ࣌ؒΛൟ๩೔ʹ
഑෼Ͱ͖Δ ݄ Ր ਫ ໦ ۚ ๏ఆ࿑ಇ࣌ؒ ࣌ؒ ͷ·· มܗ࿑ಇ੍࣌ؒ

݄ Ր ਫ ໦ ۚ ౔ ೔ ࣌ؒ֎࿑ಇ ࣌ؒ ࣌
࣌ ࣌ ࣌ ࣌ มܗ࿑ಇ੍࣌ؒ

ʢCFGPSFʣ ݄ Ր ਫ ໦ ۚ ౔ ೔ ࣌ؒ֎࿑ಇ ࣌ؒ
ʢ݄࣌ؒʣ ໷ۈ೔ ࣌ ࣌ ࣌ ࣌ ࣌ มܗ࿑ಇ੍࣌ؒ

ʢBGUFSʣ ݄ Ր ਫ ໦ ۚ ౔ ೔ ࣌ؒ֎࿑ಇ ࣌ؒ
ʢ݄࣌ؒʣ ໷ۈ೔ ࣌ ࣌ ࣌ ࣌ ࣌ ࣌ؒ֎࿑ಇ ࣌ؒ ʢ݄࣌ؒʣ มܗ࿑ಇ੍࣌ؒ

݄ Ր ਫ ໦ ۚ ౔ ೔ िʢ໷ۈ݄ճʣ ʴΦϯίʔϧ݄ճ ৗۈ̔ਓ
஍Ҭप࢈ظ ηϯλʔ" ࣌ ࣌ ࣌ ࣌ ࣌ ʢ࠶ܝʣ஍Ҭप࢈ظηϯλʔ"Ͱͷ໷ۈिճମ੍ ࣌ؒ֎࿑ಇ ࣌ؒ ݄ ࣌ؒ

݄ Ր ਫ ໦ ۚ ౔ ೔ िʢ໷ۈ݄ճʣ ʴΦϯίʔϧ݄ճ ৗۈ̔ਓ
I ºճ 㲈I ஍Ҭप࢈ظ ηϯλʔ" ࣌ ࣌ ࣌ ࣌ ࣌ ࣌ؒ֎࿑ಇ ࣌ؒ ݄ ࣌ؒ ஍Ҭप࢈ظηϯλʔ"Ͱͷ໷ۈिճମ੍

݄ Ր ਫ ໦ ۚ ౔ ೔ िʢ౰௚݄ճʣ ʴΦϯίʔϧ݄ճ ৗۈ̔ਓ
࣌ؒ֎࿑ಇ ࣌ؒ ݄ ࣌ؒ ࣌ ࣌ ࣌ ࣌ ࣌ ஍Ҭप࢈ظ ηϯλʔ" I ºճ 㲈I ౰௚໌͚ؼ୐ʢมܗ࿑ಇ੍࣌ؒʣ

݄ Ր ਫ ໦ ۚ ౔ ೔ िʢ౰௚݄ճʣ ʴΦϯίʔϧ݄ճ ৗۈ̔ਓ
࣌ؒ֎࿑ಇ ࣌ؒ ݄ ࣌ؒ ࣌ ࣌ ࣌ ࣌ ࣌ ୡ੒ʂ ஍Ҭप࢈ظ ηϯλʔ" I ºճ 㲈I ͞Βʹ࣌ؒ֎࿑ಇΛݮΒ͢౒ྗΛͯ͠

૯߹प࢈ظηϯλʔ " ࣮ࡍͷέʔεΛ౿·͑ͯ

໷ۈ͸໷͚ͩ ೔ۈ͸࣌ʹؼ୐ มܗೋަ୅ۈ຿੍౓ʢมܗ࿑ಇ੍࣌ؒͷҰͭʣ @໦ށ ಓࢠઌੜʢ೔ຊ੺ेࣈࣾҩྍηϯλʔʣ

೔தͷਓһෆ଍ ผࢪઃͰ͸ ᶃ໷ۈ ᶄ॓௚ ᶅ॓௚ ʔ̏ਓ ʔ̍ਓ ަ୅ۈ຿੍౓ͷσϝϦοτᶃ @໦ށ ಓࢠઌੜʢ೔ຊ੺ेࣈࣾҩྍηϯλʔʣ

ۈ຿ද͕൥ࡶ γϑτද ҩࢣ഑ஔද ֎དྷʢ࢈Պ්ਓՊʣ ݕ਍ɾ෼ṯ ަ୅ۈ຿੍౓ͷσϝϦοτᶄ @໦ށ ಓࢠઌੜʢ೔ຊ੺ेࣈࣾҩྍηϯλʔʣ

୲౰ҩ͕ܾ·Βͳ͍ʮަ୅੍ʯ ֎དྷ୲౰ද ަ୅ۈ຿੍౓ͷσϝϦοτᶅ @໦ށ ಓࢠઌੜʢ೔ຊ੺ेࣈࣾҩྍηϯλʔʣ

lઈରʹzඞཁͳͷ͸ ୹࣌ؒۈ຿ҩࢣͷ׆༂ʂʂ ʢ೛৷ɾग़࢈հޢຊਓͷපؾͳͲʣ ೔தͷ਍ྍͷ࣭Λҡ࣋͢ΔͨΊʹ ৄ͘͠͸ɺୈ̎ষͰɻ

ࢪઃू໿Խɾ୹࣌ؒۈ຿ऀͷ׆༻ɾॊೈͳಇ͖ํͷબ୒ࢶ ୹࣌ؒۈ຿ऀ͸ϑϧʹಇ͚ͳ͍ɹɹ ϚΠφεͷଘࡏͰ͸ͳ͘ ૊৫ʹߩݙ͢Δϓϥεͷਓࡐ ඇৗۈͰ͸ͳ͘ৗۈͱ͠ কདྷ͸ϑϧλΠϜͱͯ͠׆༻Λ มܗ࿑ಇ੍࣌ؒͰ͸ɺ೔ۈ͚ͩͷઌੜʹॿ͚ΒΕΔ @໦ށ ಓࢠઌੜʢ೔ຊ੺ेࣈࣾҩྍηϯλʔʣ

@໦ށ ಓࢠઌੜʢ೔ຊ੺ेࣈࣾҩྍηϯλʔʣ มܗ࿑ಇ੍࣌ؒ ҩྍͷඪ४Խ

࿑ಇ؀ڥվળ͕໨ࢦ͢ͱ͜Ζ @໦ށ ಓࢠઌੜʢ೔ຊ੺ेࣈࣾҩྍηϯλʔʣ

࿑ಇ؀ڥվળ͕໨ࢦ͢ͱ͜Ζ ҩྍ҆શ

ҩྍऀ͕ෆ޾ʹͳͬͯ͸͍͚ͳ͍ ҩࢣ΋ਓؒͰ͢

ҩྍऀ͕ෆ޾ʹͳͬͯ͸͍͚ͳ͍ ҩࢣ΋ਓؒͰ͢ ҩྍऀ͕݈߁Ͱ͋Δ͜ͱ ਓΛٹ͏ʹ͸ɺ·ͣࣗ෼͕݈߁Ͱͳ͚Ε͹ͳΒͳ͍ɻ ͦ͏Ͱͳ͍ͱɺ൑அΛޡΔɺελοϑ͕໎͏ɻ Ո଒͕৺഑͢Δɻࣗ෼Λ੹ΊΔɻ ΋͠΋Ωϛ͕ٹٸҩʹͳΔͷͳΒ ·ͣࣗ෼ͷ͜ͱΛ࠷༏ઌʹߟ͑ͯཉ͍͠ɻ ͦΕΛඇ೉͢Δਓ͕͍ΔͳΒ͹ɺ ࢲ͕ͨͪҾ͖ड͚Δɻ
ߴྸԽ͸ਐΉɻҩࢣ͸଍Γͳ͍ɻ ͔ͩΒͦ͜ٹٸҩ͕݈߁Ͱ͋Δ͜ͱɻ ͜Ε͸ٛ຿ͩɻ ɹ೔ຊٹٸҩֶձ

⼼臓⾎管外科学会雑誌 2012年,41巻2号, 63-66 • Young surgeons decreasing → Increased burden
on mid-career surgeons • Questionnaire Survey of doctors changed their career from CVS. (N=56) • CVS experience (mean) 15.4 year • Certified CVS 65%, experience of research/work abroad 32% “ Survey of Doctors Who Changed Their Clinical Specialty from Cardiac Surgery ” ҩྍऀ͕ෆ޾ʹͳͬͯ͸͍͚ͳ͍ ͢΂ͯͷ਍ྍՊͰ࣮ݱ͞ΕΔ΂͖ @ཱੴ ࣮ઌੜʢ੟ྴ඿দපӃ ৺ଁ݂؅֎Պʣ

ҩྍऀ͕ෆ޾ʹͳͬͯ͸͍͚ͳ͍ ࣗݾ٘ਜ਼Λڧ͍ͯ΋ɺͨͩڈΔͷΈ It should have been a hard-working career in
cardiovascular surgery… However, 77% of them do not regret quitting their CVS career. Only one person regrets it. Free comments ü There is a lot of self-sacrificing work, but the salary is not rewarding their contribution. ü Cardiac surgery cannot be performed operation in early stage, has a lot of miscellaneous work, and difficult to think the future career. ü Too Difficult to update Certified CVS. ⼼臓⾎管外科学会雑誌 2012年,41巻2号, 63-66 @ཱੴ ࣮ઌੜʢ੟ྴ඿দපӃ ৺ଁ݂؅֎Պʣ

w ҩྍΛఏڙ͢ΔපӃΛͰ͖Δ͚ͩॏ఺Խʢू໿Խʣ w ໷ۈ໌͚͸ؼ୐͢Δʮมܗ࿑ಇ੍࣌ؒʯ ཧ࿦ฤͷ·ͱΊ

͜Ε͸ҩྍऀ͚ͩͷ໰୊Ͱ͸ͳ͍ ࠃຽΛר͖ࠐΜͰٞ࿦Λߦ͍ ࣋ଓՄೳͳ࢓૊ΈΛ ͲͷΑ͏ʹσβΠϯ͢Δ͔ͱ͍͏໰୊

ॺ໊਺ ɹɹਓ ࣾձ΁ͷಇ͖͔͚ ೔ຊͷҩྍͱױऀ͞Μͷ҆શΛकΔͨΊʹ ҩࢣͷ௕࣌ؒ࿑ಇΛن੍͍ͯͩ͘͠͞

٢ాҩ੓ہ௕ʹॺ໊ఏग़

ࣲాҁࢠઌੜʢ࢈්ਓՊҩʣ ಇ͖ํվֵͷ࣮ફฤ

@ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ͋ͳͨͷ৬৔ͷ࢒ۀΛݮΒ͢ͷํ๏ ໌೔͔ΒͰ͖Δ΋ͷͭ පঢ়આ໌ͷ࣌ؒͷܝࣔ ࣌ؒ֎ʹओ࣏ҩΛݺͼग़͞ͳ͍ ৘ใڞ༗πʔϧͷಋೖɹ ޮՌ͕େ͖͍΋ͷͭ ΧϯϑΝϨϯεΛ࿑ಇ࣌ؒ಺ʹ ओ࣏ҩ੍ͷఫഇ
౰௚໌͚ͷ൒ٳ ಇ͖΍͘͢͢Δͭ ౰௚ଳͷਃ͠ૹΓɹ ҩྍࣄ຿ɾΞγελϯτͷಋೖ ฏ೔ͷ༗ٳಋೖ Ұ൪େࣄͳ΋ͷ̍ͭ ·͕ͪͬͨࢥ͍ࠐΈΛࣺͯΑ͏ ɹɹᶃ࢒ۀʹඞཁѱʁ ɹɹᶄશһ͕ಉ͡Α͏ʹಇ͔ͳ͍ͱ͍͚ͳ͍ʁɹɹ !ࣲాҁࢠʢཎ઒ΩϦετڭපӃ࢈්ਓՊʣ ͓౔࢈ ࣌ؒ֎࿑ಇΛݮΒͨ͢Ίʹඞཁͳ͜ͱ

͋ͳͨͷ৬৔ͷ࢒ۀΛݮΒ͢ͷํ๏ ͋ΔපӃͷྫ Ұ൪େࣄͳ΋ͷ̍ͭ ໌೔͔ΒͰ͖Δ࢒ۀରࡦ̏ͭ ޮՌͷߴ͍࢒ۀରࡦ̏ͭ ಇ͖΍͘͢ͳΔ࢒ۀରࡦ̏ͭ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ

࢒ۀΛ΁Β͢ʹ͸ ·͕ͪͬͨࢥ͍ࠐΈΛࣺͯΑ͏ ࢒ۀʹඞཁѱʁ શһ͕ಉ͡Α͏ʹಇ͔ͳ͍ͱ͍͚ͳ͍ʁɹɹ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ

೥લ ɾओ࣏ҩ੍ ɾ౰௚ཌ೔͸௨ৗۀ຿ ɾฏ೔௨ৗۀ຿ ɾΧϯϑΝ͸ۀ຿ޙ͔Β @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ

ؒҧͬͨঁੑҩࢣࢧԉ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ w ঁੑʹؤுΕͱݴ͏ w पғ΁ͷෛ୲͕૿͑ͨ·· w γεςϜΛม͑ͣʹਫ਼ਆ࿦ɹɹ

ݱࡏ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ɾ࣌ؒ֎ͷݺͼग़͠ແ͠ ɾ౰௚೔͸೔ۈແ͠ ɾ݄ճฏ೔ٳΈ ɾΧϯϑΝ͸࣌ؒ಺ͷΈ

໌೔͔ΒͰ͖Δ΋ͷͭ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ පঢ়આ໌ͷ࣌ؒͷܝࣔ ࣌ؒ֎ʹओ࣏ҩΛݺͼग़͞ͳ͍ ৘ใڞ༗πʔϧͷಋೖɹ

පঢ়આ໌ͷ࣌ؒͷܝࣔ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ

࣌ؒ֎ʹओ࣏ҩΛݺͼग़͞ͳ͍ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ɾࢦࣔͰ෼͔Βͳ͍͜ͱ͕͋Δ ɾ୲౰ױऀͷ༰ଶͷมԽ ɾױऀՈ଒͔Βͷපঢ়આ໌ͷґཔ ɾ఺ణ΍ༀͷೖྗɾ࡟আ ࣌ؒ֎͸౰௚ҩ͕ݪଇରԠ

ੲ ৘ใڞ༗πʔϧͷಋೖ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ΧϯϑΝϨϯε 1)4

ࠓ ৘ใڞ༗πʔϧͷಋೖ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ϝʔϦϯάϦετ ɾ౰೔ۀ຿ ɾ༧ఆมߋ ɹɹ஗ࠁɾૣୀ ɾਃ͠ૹΓ

ޮՌ͕େ͖͍΋ͷͭ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ΧϯϑΝϨϯεΛ࿑ಇ࣌ؒ಺ʹ ओ࣏ҩ੍ͷఫഇ ౰௚໌͚ͷ൒ٳ

ΧϯϑΝϨϯεΛ࿑ಇ࣌ؒ಺ʹ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ

νʔϜ੍ ओ࣏ҩ੍ͷఫഇ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ " ओ࣏ҩ͕֎དྷதɾखज़தͷରԠ # ओ࣏ҩෆࡏ೔ͷํ਑ܾఆ $ පঢ়આ໌ɾۓٸखज़ͷରԠ
w ֎དྷதɾखज़தͷి࿩ͷ਍ྍதஅ͕ݮΔ w ओ࣏ҩݺͼग़͠΍֎ઢ໰͍߹Θ͕ͤݮΔ w ෳ਺ਓͰ਍ྍ಺༰Λ֬ೝ͠ϛεΛݮΒ͢

౰௚໌͚ͷ൒ٳ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ೥݄ʙ ౰௚໌͚൒ٳ
೔໨ ೔໨ ˠ೔ۈ໷ۈ੍΁ ೥݄ʙ ౰௚ˠ໷ۈʹ ೔໨ ೔໨

ಇ͖΍͘͢͢Δͭ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ౰௚ଳͷਃ͠ૹΓɹ ҩྍࣄ຿ɾΞγελϯτͷಋೖ ฏ೔ͷ༗ٳಋೖ

౰௚ଳͷਃ͠ૹΓ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ౰௚ઐ༻1)4 ɿʙɿ ɹɹ֤ਓ͔Βݱঢ়Λਃ͠ૹΓ ˠࠓԿͷۀ຿͕࢒͍ͬͯΔͷ͔͕෼͔Δ ˠҾ͖ܧ͕͗ࣗવʹͰ͖Δ

ҩྍࣄ຿ɾΞγελϯτͷಋೖ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ҩࢣͷॻྨۀ຿ อݥؔ࿈ॻྨɹɹ೥ؒɹສ௨ ࡞੒࣌ؒɹɹɹɹ೥ؒɹສ࣌ؒ ೔ҩ૯ݚϦαʔνΤοηΠ

ҩྍࣄ຿ɾΞγελϯτͷಋೖ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ҩࢣͷॻྨۀ຿ อݥॻྨ࡞੒ɹɹҩࢣɹ ਓ෼೥ ࡞੒࣌ؒɹɹɹɹਓɹɹɹɹ࣌ؒ೥ ೔ҩ૯ݚϦαʔνΤοηΠ

ฏ೔ͷ༗ٳಋೖ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ฏ೔༗ٳʹඞཁͳ΋ͷ ᶃνʔϜ੍ ᶄ৘ใڞ༗πʔϧ ᶅ΍Δؾ

࢒ۀΛݮΒ͢ʹ͸ ·͕ͪͬͨࢥ͍ࠐΈΛࣺͯΑ͏ ࢒ۀʹඞཁѱʁ શһ͕ಉ͡Α͏ʹಇ͔ͳ͍ͱ͍͚ͳ͍ʁɹɹ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ

w ໌೔͔Βಇ͖ํվֵΛ࣮ߦ͢Δ ɹɹɹ͋ͳͨͷ৬৔ͷ࢒ۀΛݮΒ͢ͷํ๏ w ಇ͖ํվֵʹपғΛר͖ࠐΉ ࠓ͕มΘΔ࣌Ͱ͢ʂ ୈ̍ষɹΰʔϧ

ຊ೔ͷΞδΣϯμ 1. ɹࠃͷݱঢ়ͱऔ૊Έ 2. ɹঁੑҩࢣͷݱঢ় 3. ɹӃ಺อҭʹ͍ͭͯ 4. ɹපࣇอҭʹ͍ͭͯ ୈষΞδΣϯμ

ࠃͷݱঢ় ࠃͷݱঢ়

ڞಇ͖ੈଳͷਪҠ

ࠃͷݱঢ়

ࠃͷऔ૊Έ

ࠃͷࠓޙͷऔ૊Έ

ຊ೔ͷΞδΣϯμ 1. ɹࠃͷݱঢ়ͱऔ૊Έ 2. ɹঁੑҩࢣͷݱঢ় 3. ɹӃ಺อҭʹ͍ͭͯ 4. ɹපࣇอҭʹ͍ͭͯ ୈষΞδΣϯμ

ঁੑҩࢣͷਪҠ

ঁੑҩࢣͷׂ߹

ঁੑҩࢣͷबۀ཰

ঁੑҩࢣͷ཭৬ݪҼ

ঁੑҩࢣͷҭࣇͱ࢓ࣄͷཱ྆

ຊ೔ͷΞδΣϯμ

Ӄ಺อҭͱ͸

Ӄ಺อҭͷݱঢ়

Ӄ಺อҭͷϝϦοτ

Ӄ಺อҭͷσϝϦοτ

Ӄ಺อҭͰͷఏҊ ࣌ؒอҭ ༵೔Λݻఆ͢Δ͜ͱͰ ɹϦεΫΛܰݮ

ঁੑҩࢣͷಇ͖ํ

ҭࣇ΍௕͍߆ଋ࣌ؒͷͨΊৗۈΛ཭ΕΔ ಇ͖੝Γͷҩࢣ͕গͳ͘ͳ͍ ୀ৬ཧ༝

൒਺Ҏ্͕ʮຊ౰͸ৗۈͱͯ͠ಇ͖͍ͨʯ ؀ڥΛ੔͑ͯ׆༂ͯ͠΋Β͏ʹ͸ɾɾɾ ৗۈ෮ؼͷر๬

ঁੑҩࢣ͕ಇ͖΍͍͢৬৔ͮ͘Γ 平成20年度厚⽣労働科学研究補助⾦（厚⽣労働科学特別研究事業）病院勤務医等の勤務環境改善に関する研究「⼥性医師就労⽀援事例の収集・検討」より ঁੑҩࢣͷΈͳΒͣ શͯͷۈ຿ҩΛର৅ͱͨ͠ ۈ຿؀ڥͷݟ௚͠ ͪ͜Β͔Β֬ೝͰ͖·͢

೥ൃץ ˏཱੴ ࣮ઌੜ ʢ੟ྴ඿দපӃ ৺ଁ݂؅֎Պʣ

࢈්ਓՊֶձͷऔΓ૊Έ

࢈්ਓՊҩͷಇ͖ํվֵએݴ ࢈්ਓՊҩͷʮಇ͖ํվֵʯએݴͱఏݴ

ఏݴɿҩྍվֵΛ௨ͯ͡ಇ͖ํվֵΛ࣮ݱͤ͞·͠ΐ͏ ಺༰ ࢈්ਓՊҩͷʮಇ͖ํվֵʯએݴͱఏݴ

To Know 上司との定期⾯談 Ø ⾯談時の質問は雛形を学会が⽤意 Ø 実施率を学会に報告 Ø 罰則は設けないが、賞与を設ける ୈ7ճ
εϓϦϯάϑΥʔϥϜ੒Ռ෺ @త৔ ༏հઌੜʢܚጯେֶ ࢈්ਓՊʣ

To Adjust Ø イクボスの腕の⾒せどころ Ø 個々の価値観を満⾜できるように Ø 全員が70点をとれるように上司が業務調整 ୈ7ճ

ෆެฏײΛ ͍͔ʹݮΒͤΔ͔

To Evaluate 職場満⾜度アンケートを実施 Ø 上位10病院は表彰 Ø Top10の部⻑のコラムをHPで連載 Ø 上位病院に奨励⾦を授与 ୈ7ճ

ୈ8ճ εϓϦϯάϑΥʔϥϜ੒Ռ෺ @ۄ಺ ֶࢤઌੜʢ໊ݹ԰େֶ ࢈්ਓՊʣ

͜ Ͳ ΋ ͱ Ո ଒ ͷ স إ Λ
ͭ ͘Δ ɻ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜ A

҆৺ͯ͠࢈ΈҭͯΒΕΔࣾձΛͭ͘Δ 7*4*0/ Ϗδϣϯͱϛογϣϯ

ҭࣇʹؔΘΔ͢΂ͯͷਓΛসإʹ͢Δ .*44*0/ Ϗδϣϯͱϛογϣϯ

ੈքʹ͋;ΕΔ՝୊ ΞδΣϯμ

'ZKt/E' /EYh/d/^ E Wh>/ ,>d, d,Zd K& Zs/> EZ ;'>KKE
ϮϬϭϴͿ Ꮚᐑ㢕䛜䜣⨯ᝈ⋡䛾୙ᆒ⾮䛜ᗈ䛜䛳䛶䛔䛝䚸බ⾗⾨⏕ 䛾⬣ጾ䛸䛺䛳䛶䛔䜛䚹;'>KKEϮϬϭϴͿ ϮϬϭϴᖺ䛾Ꮚᐑ㢕䛜䜣䛾඲ᖺ㱋䛻ᑐ䛩䜛ᖺ㱋ㄪᩚ⨯ᝈ⋡䛾᥎ィ ᖺ㱋ㄪᩚ⨯ᝈ⋡䠄ϭϬϬ͕ϬϬϬே䛒䛯䜚䠅

&HUYLFDO FDQFHU FDVH Zs/> EZ >/D/Ed/KE͗ KEWdh> &ZDtKZ< ⌧≧ࡢ࣡ࢡࢳࣥ᥋✀࡜᳨デ ᚭᗏⓗ࡞᳨デ࡜࣡
ࢡࢳࣥ᥋✀ ᚭᗏⓗ࡞ ࣡ࢡࢳࣥ᥋✀ ᖺ ᖺ ᖺ ᖺ Ꮚᐑ㢕䛜䜣䛾᤼㝖 ௓ධ᪉ἲ䛤䛸䛾⤒㐣䛾ண᝿ ϭϬ୓ே䛒䛯䜚䛾Ꮚᐑ㢕䛜䜣⑕౛ᩘ

՝୊ײ ɹୈճੜ׆श׳පֶձ ࡾେੜ׆श׳පͷະ࣏ྍ཰

՝୊ײ σδλϧϋϦ΢ουେֶӃ।ڭत ޒेཛྷ݈༞ઌੜεϥΠυ ʢվฤʣ ಺Պֶత ҩༀ඼ ֎Պֶత खज़ ҩྍػث ࣾձֶత
/&8 ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ࣬ױ΁ͷΞϓϩʔν Ξϓϩʔν ΫϦΤΠςΟϒ ΤϯλʔςΠϝϯτ ίϛϡχέʔγϣϯ σβΠϯ ήʔϛϑΟέʔγϣϯ ͳͲ ҩༀ඼ ҩྍػث

Θ͕ͨ͠ղܾ͍ͨ͠՝୊

ݽҭͯ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ࢠҭͯͷ ᶸݱ৔ᶹ ࢈ޙ͏ͭ ٮ଴

ࢠҭͯͷ ᶸݱ৔ᶹ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ੜ׆ʼʼ࣏ྍ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ҩࢣ͕ίϛϡχέʔγϣϯΛ औΕΔͷ͸ίί͚ͩ ੜ׆ U U ҩྍػؔ
ೖӃ ୀӃ ҩࢣͷհೖظؒ͸ݶఆ͞Ε͍ͯΔ ೔ຊ͏Μֶ͜ձձ௕ ੴҪ༸հઌੜΑΓڞ༗ ʢվฤʣ ࣏ྍ ೛৷ ෼ส

Զ͸ Կͨ͠Βɺ͍͍Μͩʁ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ౴͑͸͙͢ʹ͸ग़ͳ͍

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ࢠҭͯͷ ᶸݱ৔ᶹ ͜Ͳ΋ͷපؾͰ ࢓ࣄΛٳΉ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ࢠҭͯͷ ᶸݱ৔ᶹ ͜Ͳ΋ͷපؾͰ ࢓ࣄΛٳΉ ୀ৬

Կ͕ى͖͍ͯΔͷ͔ ҭࣇ͍ͯ͠Δਓ .05)&3 ্࢘ #044 ಉ྅ $0--&"(6& ಥવͷ ࢠͲ΋ͷ පؾ
ਃ͠༁ͳ͍ʜ ࢓ํͳ͍Αʂ ݁ߏͭΒ͍ʂ ͓ࢠ͞ΜΛݟͯ͋͛ͯʂ େࣄͳ࢓ࣄ͸ པΊͳ͍ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE

ҭࣇ͍ͯ͠Δਓ .05)&3 ্࢘ #044 ಉ྅ $0--&"(6& ಥવͷ ࢠͲ΋ͷ පؾ ਃ͠༁ͳ͍ʜ
࢓ํͳ͍Αʂ ݁ߏͭΒ͍ʂ ͓ࢠ͞ΜΛݟͯ͋͛ͯʂ େࣄͳ࢓ࣄ͸ པΊͳ͍ Կ͕ى͖͍ͯΔͷ͔ ཭৬ͷ ϦεΫ ΩϟϦΞ ࢧԉ ͷࣦഊ ੜ࢈ੑͷ ௿Լ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE

ʮ୭͕ѱ͍ͷ͔ʁʯ Ͱ͸ͳ͍ ΈΜͳѱ͘ͳ͍ ΈΜͳ͠ΜͲ͍ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE

ࢠڙͷٸප࣌ͷ ࢓ࣄͷௐ੔ ެӹࡒஂ๏ਓ஍ํܦࡁ૯߹ݚڀॴɹঁੑͷ࢓ࣄͱࢠҭͯʹؔ͢Δௐࠪ ʢ೥݄ʣ Λݩʹ࡞੒
ಇ͓͘฼͞Μ͕࠷΋ࠔΔ͜ͱ ೥ؒղܾͰ͖͍ͯͳ͍՝୊ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE

පࣇ ʢʹܰ঱ͷࢠͲ΋ʣ อҭԂ͸༬͔ͬͯ͘Εͳ͍ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE පࣇอҭ

පࣇอҭ පࣇͷҰ࣌༬͔Γࢪઃ έΞͱอҭΛߦ͏ පࣇอҭࢪઃ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE

පࣇอҭ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ҩྍػؔซઃ อҭԂซઃ
୯ಠܕɾͦͷଞ ग़యɿ ʮපࣇɾපޙࣇอҭͷ࣮ଶ೺Ѳͱ࣭޲্ʹؔ͢Δݚڀʯ ʢฏ੒25೥౓ްੜ࿑ಇՊֶݚڀඅิॿۚʣ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE පࣇอҭ

පࣇอҭ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ՝୊ɿར༻཰͕௿͍ ར༻཰ ग़యɿ ʮපࣇɾපޙࣇอҭͷ࣮ଶ೺Ѳͱ࣭޲্ʹؔ͢Δݚڀʯ ʢฏ੒25೥౓ްੜ࿑ಇՊֶݚڀඅิॿۚʣ

࢖͍ͮΒ͍ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ར༻཰͕௿͍ཧ༝͸ʜ ग़యɿ ʮපࣇɾපޙࣇอҭͷ࣮ଶ೺Ѳͱ࣭޲্ʹؔ͢Δݚڀʯ ʢฏ੒25೥౓ްੜ࿑ಇՊֶݚڀඅิॿۚʣ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ࢖͍ͮΒ͍පࣇอҭͷϑϩʔ ࢠͲ΋ ൃ঱ ༧໿ ਍࡯ ೖࣨ
อҭ ܾࡁ ࣄલ ొ࿥

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜ පࣇอҭͷར༻Λ εϚϗͰ γϯϓϧʹɻ

ͦͯ͠ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ΫϨΠδʔʹ ىۀ

͜Ε·Ͱ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE

ɹ ࣮ূ࣮ݧελʔτ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜ ࣌ؒ ΦϯϥΠϯ༧໿ -*/&ͰΧϯλϯ ༧໿ˍΩϟϯηϧ ϦϚΠϯμʔ
஍ਤˍϦετͰ Χϯλϯݕࡧ ࢪઃͱอޢऀͷ ίϛϡχέʔγϣϯػೳ ࠷దͳ ࣗಈ෦԰ׂΓ ࣄલొ࿥ͳͲͷ ॻྨखଓΦϯϥΠϯԽ ֤ࢪઃઐ༻ͷ ৄࡉϖʔδ ΦϯϥΠϯ໰਍ ۭ͖ঢ়گͷ ݟ͑ΔԽ Ωϟϯηϧ଴ͪ ࣗಈ܁Γ্͛ ෳ਺ࢪઃΛ ༏ઌॱҐΛ͚ͭͯ༧໿ อҭه࿥ͷ ϦΞϧλΠϜڞ༗

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜ ࣌ؒ ΦϯϥΠϯ༧໿ -*/&ͰΧϯλϯ ༧໿ˍΩϟϯηϧ ϦϚΠϯμʔ
஍ਤˍϦετͰ Χϯλϯݕࡧ ࢪઃͱอޢऀͷ ίϛϡχέʔγϣϯػೳ ࠷దͳ ࣗಈ෦԰ׂΓ ࣄલొ࿥ͳͲͷ ॻྨखଓΦϯϥΠϯԽ ֤ࢪઃઐ༻ͷ ৄࡉϖʔδ ΦϯϥΠϯ໰਍ ۭ͖ঢ়گͷ ݟ͑ΔԽ Ωϟϯηϧ଴ͪ ࣗಈ܁Γ্͛ ෳ਺ࢪઃΛ ༏ઌॱҐΛ͚ͭͯ༧໿ อҭه࿥ͷ ϦΞϧλΠϜڞ༗ ஍ਤˍϦετͰ Χϯλϯݕࡧ ࠷దͳ ࣗಈ෦԰ׂΓ ۭ͖ঢ়گͷ ݟ͑ΔԽ Ωϟϯηϧ଴ͪ ࣗಈ܁Γ্͛ ෳ਺ࢪઃΛ ༏ઌॱҐΛ͚ͭͯ༧໿

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜʹΑΔ ʮݟ͑ΔԽʯ ͔͋ͣΔͪ͜ΌΜ ۭ ຬ ۭ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜʹΑΔ ʮݟ͑ΔԽʯ ۭ ̍ Ωϟϯηϧ ଴ͪ
̎ ֬ఆ

ۭ ̍ Ωϟϯηϧ ଴ͪ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ̍ ֬ఆ
Ωϟϯηϧ ෳ਺༧໿ʹΑΔࣗಈγϑτ ͔͋ͣΔͪ͜ΌΜʹΑΔ ʮݟ͑ΔԽʯ ̎ ֬ఆ ۭ ܁Γ্͛

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ΦϯϥΠϯ໰਍ ෳ਺༧໿ʹΑΔࣗಈγϑτ ΦϯϥΠϯ໰਍Ͱ ड਍લʹ৘ใೖྗ͸ ׬͍ྃͯ͠Δɻ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ΦϯϥΠϯ໰਍ -*/& ࢖͍΍͍͢ ࢴ͕ͳ͘ ͳͬͯϥΫ ࣌ؒ༧໿
͏Ε͍͠ ࣄલͷ ৘ใೖྗ ॿ͔Δ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜͷϏδωεϞσϧ ΦϯϥΠϯ໰਍ ϏδωεϞσϧಛڐ ʢಛڐୈ߸ʣ ར༻ऀ ແྉ
පࣇอҭࣨ ར༻ྉ ࢢ۠ொଜ ར༻ྉ ັྗ͋Δ ֗ͮ͘Γ΁

Q̍ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE Ͱ΋ʜ ͔͋ͣΔͪ͜ΌΜͷϏδωεϞσϧ පࣇอҭͬͯ χονͩΑͶʁ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE පࣇอҭ͸ӈݞ্͕Γ Ͱ΋ʜ )
) ࢪઃ਺ ར༻ਓ਺ ࢪઃ )೥ݟࠐΈ ສਓ )೥ ར༻཰ͷ Ξοϓͳ͠

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ްੜ࿑ಇলͷ਺஋໨ඪ ) ) ར༻ਓ਺
ສਓ ) ഒ ສਓ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ) ) ສਓ )
ഒҎ্ ສਓ ڻ͖ͷજࡏχʔζ ར༻ਓ਺ ສਓ

Q̎ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ՝୊͸ ʮ࢖͍ͮΒ͞ʯ ͚ͩͰ͸ͳ͍ ڻ͖ͷજࡏχʔζ ࢖͍΍͘͢͢Ε͹ ຊ౰ʹղܾ͢Δʁ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ར༻ܦݧͳ͠ ར༻ܦݧ͋Γ
ࣗࣾΞϯέʔτʜʜର৅ɿපࣇอҭର৅೥ྸͷࢠͲ΋Λ΋ͭब࿑ঁੑਓ ʢશࠃʣ ՝୊͸ ʮ࢖͍ͮΒ͞ʯ ͚ͩͰ͸ͳ͍

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ࣗࣾΞϯέʔτʜʜର৅ɿපࣇอҭର৅೥ྸͷࢠͲ΋Λ΋ͭब࿑ঁੑਓ ʢશࠃʣ ·ͬͨ͘஌Βͳ͍ ໊લ͔͠஌Βͳ͍ ࢖͍ํ͸஌͍ͬͯΔ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜͰ໨ࢦ͢ੈք ࣗࣾΞϯέʔτʜʜର৅ɿපࣇอҭର৅೥ྸͷࢠͲ΋Λ΋ͭब࿑ঁੑਓ ʢશࠃʣ ࢖͍ͬͯΔ ஌Βͳ͍ ͖͋ΒΊͨ
જࡏސ٬

஌͍ͬͯΔ ࢖͍ͬͯΔ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜͰ໨ࢦ͢ੈք ࢖͍ͬͯΔ ϙʔλϧαΠτ ͜Μͳͷ
͋ΔΜͩʂ ࢖͑Δͱ͜ ͋Δ͡ΌΜʂ ར༻ਓ਺ɹ61ɹ

Q̏ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ߴ͍ਫ४Ͱ࣮ݱ͢ΔͨΊͷνʔϜͮ͘Γ ϢʔβʔΠϯλʔϑΣʔεͷΠϝʔδ ຊ౰ʹ࣮ݱͰ͖Δʁ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ߴ͍ਫ४Ͱ࣮ݱ͢ΔͨΊͷνʔϜͮ͘Γ $&0 ࢈්ਓՊҩ $.0 খࣇՊҩ $90
69σβΠφʔ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ߴ͍ਫ४Ͱ࣮ݱ͢ΔͨΊͷνʔϜͮ͘Γ 69 6*σβΠϯ อҭɾ ҩྍઐ໳৬
ʢاըɾӦۀʣ ޿ใ පࣇอҭ ઐ໳࢜ ॿ࢈ࢣ ҩֶੜ ࢈්ਓՊҩ ݺٵث಺Պҩ පࣇอҭܦӦऀ Πϯλʔϯ ޿ใ ։ൃ࣮૷ BOE :06 σβΠφʔ 6*σβΠφʔ ٕज़ސ໰ ΤϯδχΞ ΤϯδχΞ ΤϯδχΞ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ߴ͍ਫ४Ͱ࣮ݱ͢ΔͨΊͷνʔϜͮ͘Γ ؂म େ઒༸ೋઌੜ શࠃපࣇอҭڠٞձձ௕ େ઒͜Ͳ΋ˍ಺ՊΫϦχοΫӃ௕ ͏͗͞ͷϚϚࢪઃ௕

ߴ͍ਫ४Ͱ࣮ݱ͢ΔͨΊͷνʔϜͮ͘Γ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ݱ৔͕νʔϜϝϯόʔʂ

࢈׭ֶͷ࿈ܞ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ݱ৔͕νʔϜϝϯόʔʂ ࢈ .63$ "4"$ ׭
ްੜ࿑ಇল ࢢ۠ொଜ ٞһ ౦ژ౎ ֶ ֶձൃද පࣇอҭڠٞձ ౦େެऺӴੜ ࢈්ਓՊֶձ A ՝୊ղܾ

පӃ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ࢠͲ΋ʹ҆৺ͷωοτϫʔΫߏங΁ ࢢ۠ொଜ اۀ පࣇอҭϓϥοτϑΥʔϜ පࣇอҭ㱻อҭ

ºίϛϡχςΟ ࢠҭͯ

ºίϛϡχςΟ ҩྍ

ºίϛϡχςΟ ҩྍ ҩࢣձ

ºපࣇอҭ ҩࢣձ

ҊᶃපࣇอҭࢪઃΛ࡞Δʂ ౦ژ౎େా۠ େ৿ҩࢣձ

Ҋᶄࠓ͋ΔපࣇอҭࢪઃΛ࢖͍΍͘͢͢Δ පࣇอҭͷར༻Λ εϚϗͰ γϯϓϧʹɻ

Ҋᶅࠓ͋ΔපࣇอҭࢪઃΛ࢖͍΍͘͢͢Δʢૹܴࣄۀʣ පࣇอҭϓϥοτϑΥʔϜ อҭԂϓϥοτϑΥʔϜ ૹܴ͢Δਓ

Ҋᶆࢢ୯ҐͰපࣇอҭࢪઃΛ࢖͍΍͘͢͢Δ ར༻ऀ ແྉ පࣇอҭࣨ ར༻ྉ ࢢ۠ொଜ ར༻ྉ ັྗ͋Δ ֗ͮ͘Γ΁

શࠃͱͷൺֱ ҵ৓ݝ ɹ࠽ະຬਓޱ ɹສਓ શࠃฏۉϨϕϧͳΒ ɹࢪઃ ࣮ࡍͷࢪઃ਺ ɹࢪઃ ਫށࢢ ɹ࠽ະຬਓޱ
ɹສਓ શࠃฏۉϨϕϧͳΒ ɹࢪઃ ࣮ࡍͷࢪઃ਺ ɹࢪઃ ࠽ະຬਓޱͰܭࢉ͠ɺ શࠃฏۉΑΓ΋ ଟ͍ࢪઃΛ࣏࣋ͭࣗମ͕੺ গͳ͍৔߹ɺ ੨Ͱදࣔ ϦϯΫ͸ͪ͜ΒΛΫϦοΫ

Ҋᶇݝ୯ҐͰපࣇอҭࢪઃΛ࢖͍΍͘͢͢ΔʢࢁསݝͷऔΓ૊Έʣ ઌਐࣄྫɿࢁསݝͷऔΓ૊Έ ޿Ҭར༻ ΦϯϥΠϯࣄલొ࿥

Ҋᶈҩࢣձһઐ༻࿮ͷ૑ग़ ఆһ໊ ৬һ༻໊̎

Ҋᶈҩࢣձһઐ༻࿮ͷ૑ग़ ఆһ໊ ৬һ༻໊̎ ஍Ҭͷࢪઃʹҩࢣձ࿮Λ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ҩࢣͱ͸ ҩࢣ๏ୈҰ৚ɹ ɹҩࢣ͸ɺҩྍٴͼอ݈ࢦಋΛঠΔ͜ͱʹΑͭͯ ɹެऺӴੜͷ޲্ٴͼ૿ਐʹد༩͠ɺ ɹ΋ͭͯࠃຽͷ݈߁ͳੜ׆Λ֬อ͢Δ΋ͷͱ͢Δɻ ҩࢣͱ͸

l4VDDFTTJTOPUpOBM GBJMVSFJTOPUGBUBM JUJTUIFDPVSBHFUPDPOUJOVFUIBUDPVOUTz ੒ޭ͸ΞΨΓͰ͸ͳ͘ɺࣦഊ͸க໋తͰ͸ͳ͍ɻ େ੾ͳͷ͸ଓ͚Δ༐ؾͩ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜ ҭࣇʹؔΘΔ͢΂ͯͷਓΛসإʹ͢Δ .*44*0/

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜ ࢠҭͯΛϋοϐʔʹʂ

ࠓճ͸وॏͳ৔Λ࡞͍͍ͬͯͨͩͨॾԬ৳༟ઌੜʢἚ৓ݝҩࢣձձ௕ʣɺຬ઒ݩҰઌੜʢἚ৓ݝҩ ࢣձ෭ձ௕ʣɺ੨໦͔ΛཬઌੜʢἚ৓ݝҩࢣձஉঁڞಉࢀըҕһձҕһ௕ʣɺ஛த৻ઌੜʢਫށ੺ ेࣈපӃ࢈්ਓՊ෦௕ʣʹਂ͘ײँ͍ͨ͠·͢ɻ ͜ͷ෼໺Ͱͣͬͱਚྗ͞Ε͖ͯͨւ໺৴໵ڭतʢ๺ཬେֶ࢈්ਓՊʣɺதҪষਓڭतʢ೔ຊҩՊେ ֶ࢈්ਓՊʣɺ໦ށಓࢠ෦௕ʢ೔ຊ੺ेࣈҩྍηϯλʔʣɺएखͰ͋ΔΘͨ͠Λ͍ͭ΋Թ͔͘ࢦಋ ͩͬͨ͘͞ҩྍվֵҕһձͷઌੜํɺوॏͳ͝ҙݟ΍εϥΠυͷఏڙΛ௖ଷͨ͠ɺখদ޺জઌੜ ʢௗऔେֶ࢈්ਓՊʣɺత৔༏հઌੜʢܚጯେֶ࢈්ਓՊʣɺࣲాҁࢠઌੜʢཎ઒ΩϦετڭපӃ ࢈්ਓՊʣɺۄ಺ֶࢤઌੜʢ໊ݹ԰େֶ࢈්ਓՊʣɺཱੴ࣮ઌੜʢ੟ྴ඿দපӃ৺ଁ݂؅֎ Պʣɺશࠃͷ෼ṯࢪઃʹ͓͚Δಇ͖ํվֵௐࠪΛڞʹղੳɾݕ౼ͨ͠ླ໦ਅઌੜʢُా૯߹ප Ӄʣɺॏݟେհઌੜʢ౦ژେֶେֶӃྟচӸֶڭࣨʣɺখ໺݈ଠ࿠ઌੜʢ੟࿏ՃපӃ࢈්ਓՊʣɺ
ߔޱതॏ͞Μʢגࣜձࣾ".**ʣʹਂ͘ײँ͍ͨ͠·͢ɻ ࠷ޙʹɺࣾձىۀՈͱͯ͠ͷಇ͖ํΛԠԉͯͩ͘͠͞Δ౻Ҫ஌ߦڭतɺେਢլয়ڭतɺ౦ژେֶ࢈ ්ਓՊڭࣨͷઌੜํʹ͸͍ͭ΋ਂ͘ײँ͓ͯ͠Γ·͢ɻ ँࣙ

ิॿۚʹ͍ͭͯ

جຊ෼ ສԁ Ճࢉ෼ ສԁ ਓຖʹ ໿ສԁͣͭ Ճࢉ෼Ξοϓ ྫ ਓར༻ ਓϨϯδ
جຊ෼ ສԁ ສԁ ສԁ ް࿑লϞσϧ

පࣇอҭࣨར༻཰ ೥ؒ ਓ͕ར༻ʹ ສԁͷ৔߹ ౎ಓ෎ݝ ࠃ ʕ
ສԁ ʕ ສԁ ࢢ۠ொଜ ʴ ʕ ສԁ ສԁ පࣇอҭࣨ පࣇରԠܕิॿۚ

පࣇอҭࣨར༻཰ ೥ؒ ਓ͕ར༻ʹ ສԁͷ৔߹ ࢢ۠ொଜ ສԁ පࣇอҭࣨ ར༻ྉ
ԁºਓ㲈ສԁ ສԁ ؃ޢࢣºਓ ສԁ อҭ࢜ºਓ ສԁ ʴ ύʔτ ʴ Ո௞ ʴ อҭؔ࿈ ʴ ࡶඅ ʜ௿͍ පࣇରԠܕิॿۚ

ࢢ۠ொଜ පࣇอҭࣨ ް࿑লϞσϧ ैྔ੍ ఆֹ පࣇରԠܕิॿۚ

පࣇରԠܕิॿۚ ް࿑লϞσϧ ैྔ੍ ఆֹ ར༻ਓ਺ʹΑΒͣ҆ఆ ར༻ਓ਺ΞοϓͰ ऩӹ΋Ξοϓ

ར༻ྉ ສԁ ఆһ໊ ར༻཰ ೥ؒར༻ ਓ ʴສԁ ຊདྷͷิॿʢສԁʣΑΓ ࢢͷෛ୲
ʢࢧग़ʔิॿۚʔར༻ྉʣ ࠃɾݝɾࢢ͕ ສԁ ͣͭෛ୲ ສԁ º ʔ ʹສԁ ར༻཰͕ݱঢ় ʢ"ࢢͷ࣮ྫʣ පࣇอҭࣨ ສԁ ౎ಓ෎ݝ ࠃ "ࢢ ສԁ ར༻ਓ਺͕Ξοϓ͢Δͱɺࢢ۠ொଜͷෛ୲͸ݮগ͢Δ

ར༻ྉ ສԁ ೥ؒར༻ ਓ ສԁ ຊདྷͷิॿʢສԁʣΑΓ ఆһ໊ ར༻཰
ࢢͷෛ୲ ʢࢧग़ʔิॿۚʔར༻ྉʣ ར༻཰͕ݱঢ় ͔Β ·Ͱ্ঢͨ͠৔߹ʢ"ࢢͷγϛϨʔγϣϯʣ පࣇอҭࣨ ສԁ ࠃɾݝɾࢢ͕ ສԁ ͣͭෛ୲ ສԁ º ʔ ʹ ສԁ ౎ಓ෎ݝ ࠃ "ࢢ ิॿۚ ʴສԁ ສԁ ࢢͷෛ୲ ສԁ ར༻ਓ਺͕Ξοϓ͢Δͱɺࢢ۠ொଜͷෛ୲͸ݮগ͢Δ

ࢀর

（2017） Operating Room 15 Number of operations 10,578 General anesthesia
6,719 SEIREI HAMAMATSU GENERAL HOSPITAL “Task shifting / sharing” PBPM (Pharmacy-based protocol medication) : Based on the protocol, pharmacist order for continuous / shortage prescriptions, correct the inappropriate order, plan and propose the dosage design, point out the side-effects…etc. ü Pharmacist ü Nurse Specialized cardiovascular surgery NP will put in from April 2020 ü Clinical Engineer 78 CEs work in our hospital, 20-28 CEs exclusively works in operating room. They manage and organize robot surgery, implantable equipment, Laparoscope, and support anesthesiologists.

࢓ࣄͱҭࣇͷཱ྆ʹඞཁͳ΋ͷ

ୈճ ࢈්ਓՊಈ޲ҙࣝௐࠪɾλεΫγϑτௐࠪ ͔Βݟ͑ͨ͜ͱ ʮप࢈ظҩྍͷ޿৔ʯͷ)1ʹͪ͜Βͷใࠂ͕͋Γ·͢ɻ

ग़య ฏ੒30೥౓ʮ֦େҩྍվֵҕһձʯ݉ ʮ࢈්ਓՊҩྍվֵ ެ։ϑΥʔϥϜʯ ೔ຊҩՊେֶ தҪষਓڭत࡞੒ࢿྉ ʢࢀߟʣ໷ۈҎ֎ͷ࣌ؒ֎࿑ಇ͸ݮগ܏޲

ҩࢣिͷ࿑ಇ࣌ؒࠃࡍൺֱ ि࿑ಇ࣌ؒͷҩࢣஉঁ೥୅ผࠃࡍൺֱɺ0&$%EBUB ग़య 2006೥OECD dataɺ2006೥ࠃཱอ݈ҩྍՊֶӃλΠϜελσΟͷௐࠪ݁ՌΑΓ ౦ژେֶҩՊֶݚڀॴ ౬஑ߊҰ࿠ઌੜ࡞੒ ʢ໷ۈΛআ͘ʣ ฏۉతͳ࣌ؒ֎࿑ಇ͸ ݮগ͍ͯ͠Δͷ͸
લड़ͷௐࠪΑΓ͔͕֬ͩ एखҩࢣ͸ ฏۉΑΓ΋௕࣌ؒ࿑ಇΛ ͍ͯ͠Δͱ༧૝͞ΕΔ ˞ࢲݟͰ͸ɺେֶͳͲͰ ɹ໾৬ʹ͍͍ͭͯΔઌੜ͸ ɹएखಉ༷͔ͦΕҎ্ʹ ɹ௕࣌ؒ࿑ಇ͍ͯ͠Δ ʢࢀߟʣ೔ຊͷएखҩࢣ͸ɺଞࠃΑΓ΋௕࣌ؒ࿑ಇ͍ͯ͠Δ

؃ޢ৬΁ͷλεΫγϑτ ɹ೛৷தظҎ߱ͷ೛්݈਍͸ɺҩࢣ֎དྷͱॿ࢈ࢣ֎དྷ͕ ɹަޓʹͳΔΑ͏ʹ݈਍εέδϡʔϧΛ૊Ή ɹˠҩࢣͷ֎དྷۀ຿෼୲͕΄΅൒ݮ ɹɹɹʢۀ຿಺༰ʣҩࢣɿ௒Ի೾ݕࠪɺҩֶతҟৗͷૣظൃݟ ɹɹɹɹɹɹॿ࢈ࢣɿอ݈ࢦಋɾೕ๪έΞͳͲ ઐ໳৬ͷػೳΛੜ͔ͨ͠λεΫγΣΞ ɹӃ಺ॿ࢈΍࢈ޙέΞʹ͓͍ͯ΋ॿ࢈ࢣͱڠಇ ೔தͷਓखෆ଍Λٹ͏ʹ͸ʮνʔϜҩྍʯͷ࣮ݱΛʂ

ҩྍࣄ຿ิॿऀʹΑΔॻྨ࡞੒΍ೖྗ࡞ۀͷ୅ߦ ɹˠҩࢣͷࣄ຿࡞ۀෛ୲͕ݮগॻྨ࡞੒ͷ஗Ԇ΍ ɹɹೖྗ࿙Ε͕ͳ͘ͳΓӃ಺ۀ຿͕ԁ׈Խ ໾ׂ෼୲ਪਐҕһձʹͯఆظతʹۀ຿಺༰Λݟ௚͠ ɹɹ ೔தͷਓखෆ଍Λٹ͏ʹ͸ʮνʔϜҩྍʯͷ࣮ݱΛʂ

࣌ؒ ࣌ؒҎ্ ໿ഒʂ ೔࣌ؒʙ࣌ؒಇ͍ͨਓͱൺֱͯ͠೔࣌ؒҎ্ಇ͍ͨਓͰ͸ ৺ے伷࠹Λൃ঱͢ΔϦεΫ͕̎̕ഒ 8PSLJOHIPVSTBTBSJTLGBDUPSGPSBDVUFNZPDBSEJBMJOGBSDUJPOJO+BQBODBTFDPOUSPMTUVEZ4PLFKJNB4FUBM#.+4FQ ೔ͷਭ຾͕࣌ؒະຬͰ͸݂ѹ্ঢɺڱ৺঱΍৺ے伷࠹ͷϦεΫ্ঢ 4MFFQEJTPSEFSTJOSFMBUJPOUPDPSPOBSZIFBSUEJTFBTF1BSUJOFO.FUBM"DUB.FE4DBOE4VQQM
ա࿑ͷѱӨڹ

JAMA. 2005 Sep 7;294(9):1025-33. ҩྍ҆શ΁ͷӨڹ

๩͍͠໷ۈ໌͚ͷूதྗ͸ ΄Ζਲ͍ঢ়ଶΑΓԼ͕͍ͬͯΔ 175ςετ ࣋ଓॲཧ՝୊ςετ ӡసγϛϡϨʔγϣϯ ҩྍ҆શ΁ͷӨڹ

*5ͳͲͷ׆༻

౰ӃͰ෼ṯ༧ఆͷ೛࢈්ͷ֎དྷݕ਍Λ஍ҬͷΫϦχοΫʹҕୗ Ұ෦͸*5׆༻Ͱ਍ྍ৘ใΛڞ༗ ප਍࿈ܞ

Ѫඤݝ࢛ࠃதԝࢢ ੴ઒ه೦ձ)*50පӃ ཧֶྍ๏࢜ IUUQTUFDIOJLLFJCQDPKQENBUDMGFBUVSF 45IFBMUI1 *5ͷ׆༻

εϚϗΞϓϦͳͲͷ࢖͍ํΛ ڭ͑ͯ͘ΕΔΧ΢ϯλʔ IUUQTUFDIOJLLFJCQDPKQENBUDMGFBUVSF 45IFBMUI1 *5ͷ׆༻

働き方改革を支える病児保育

働き方改革を支える病児保育

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