B 1 Micro Data Analysis on the Typical Diseases 2 2001 3 ( ) By Hippocrates,,, pp. 1017-1018. 1. 1 B ( ) Dr. Theodore Hitiris (The University of York) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 2 Correspondence to: e-mail; ged0109@srv.cc.hit-u.ac.jp (Hosoya), HZA02554@nifty.ne.jp (Hayashi), hirocky@mx2.nisiq.net (Kon-no), BYN01741@niftyserve.or.jp (Tokita). 186-8601 2-1 531. 1
65 4 2025 7 3 ( ) 4 collaboration 4 ( ) ( ) fact finding 1 ( ) 1 3 2
1 1 2 3 2 9 5 ( ) 14 ( ) ( ) 4 14 3 5 4 ICD-9 ( 9 : International Classification of Diseases) (145 ) 5 McPherson, Wennberg, Hovind, and Clifford (1982) (systematic component of variation) 3
(1983) 50 1 1 1 (1997) (1998, 4 ) ) ) ) count data 1 ( 2-a 4-a 6-a) 3 6 small area variations Cain and Diehr (1992) Gittelsohn and Powe (1995) Folland, Goodman, and Stano (1997, Ch. 10) Phelps (2000) 6 3 4
1 7 : : : ( ) 2 3 3 3.1. 3.2. 3.3. 3 ( ) 10 8 4 2. 9 9 ID 7 private 8 10 1 2 1 9 5
(5 ) 12 1 1 12 3 16 8 97 5 3. 3.1. 3.1.1. 2 8 3 2,384 1 7,781 2 1 5 10 23 5,000 ( 14 9,000 8 6,000 ) 0.2 % 50 70 10 10 ( ) 2 Web (http://www.hyo-med.ac.jp/012.html/indexmk.htm) 6
( ) 1 7 8 14 1 4 1 1 (75 79 : 60 : 47 : 47 ) ( 3) 1 ( ) 3 ( 2 ) 3 ( ) 70 11 75 79 7,300 ( : 9,800 : 2,500 ) 9 9 1,629,690 1,440,000 1,495,747 12 13 75 79 1.6 3.9 1 ( 1) ( 2) ( 6) 11 : 4 6,000 : 1 5,000 : 3 5,000 12 9 ( ) 2 8 1,797,022 0.8 13 70 74 : 18 2,000 : 11 6,000 : 15 6,000 75 79 : 11 8,000 : 7 3,000 : 9 8,000 7
3 14 4 1 10 70 100 6 1 70 1 8 1 50 2 3 8 75 15 10 70 16 70 74 7 : 4,100 : 2,600 : 5,800 16 1 ( 9) ( 13) 13 50 2 3 14 15 70 74 : 2.9 : 2.7 : 2.8 75 79 : 3.0 : 2.3 : 2.8 > > 8
17 75 ( 3 ) 2 3.1.2. ( ) 10 2-a 2-b 2-a 1 18 2-a 2-b 70 IHM3 IHM5 16.57 20.20 16 : 9,600 : 5,700 : 1 2,000 17 1 18 1 9
80 64 ( 5 ) 10 20 2-a 1 2-b 70 1 12 1 2 2 ( 2.5 ) ( ) 10
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3.2. 3.2.1. 5 10 13 3,000 7 4,000 5 9,000 0.1 40 30 700 19 1995 57.96 20 21 22 3 15 21 22 28 3 15 1 1 70 74 80 60 60 1 17 19 1 20 15.3 21 7 22 Web http://www.ncvc.go.jp/cvdinfo/sick/sick5.html 12
17 16 17 ( ) 3 70 74 5,000 7,500 2,000 1 3 23 1 15 16 17 24 18 3 1 1 19 3 26 20 1 60 23 20 18 1 17 1 22 1 3 50 23 24 13
40 4 4 2 1 23 60 24 65 45 75 60 25 3 5 40 50 2 40 50 3 22 1 22 1 3 25 25 25 3 14
26 26 5 11 15 2 5 11 15 28 26 28 1 5 1 11 15 1 3 2 1 3.2.2. 10 ( ) 15
4-a 4-b 4-a 1 4-a 4-b 10 4-a JCM1 50 2 1 26 2 2 1 1 4-a 3 26 16
4-b 10 3 2 1 1 1 4-a 1 1 1 2 3 1 3 1 1 3 1 17
1 1 1 1 3.3. 27 3.3.1. 44 9,000 23 4,000 21 4,000 0.4 70 22 28 10 20 40 80 27 ( ) ( ) ( : ) ( ) 28 8 10 18
30 50 60 10 50 5 50 29 30 29 35 36 42 5 30 20 45 70 29 31 ( ) 5 32 20 25 25 35 31 32 ( ) 33 29 1995 30 32 31 19
90 31 34 37 10 20 44 20 60 40 8 1 2 1 36 32 5 15 70 3.3.2. ( ) 10 6-a 6-b 6-a 20
1 6-a 3.3.1 50 60 60 28 29 300 30 27 26 30 6 7 2 3 1 7,000 14,000 10 10 10,000 2 1 2,000 300 60 6-a SHM1 SHF1 SCF1 21
6-b 50 1 3 4 1 1,000 73 74 7 8 2 4 1 1,000 3 4. 3 2 1 1 22
1 1 2 1 2 23
3 3 4 Cain, K. C., and P. Diehr. (1992) Testing the Null Hypothesis in Small Area Analysis, Health Services Research, Vol. 27, No. 3, pp. 267-294. Folland, S., A. C. Goodman., and M. Stano. (1997) The Economics of Health and Health Care, 2 nd ed., Upper Saddle River, Prentice Hall. Gittelsohn, A., and N. R. Powe. (1995) Small Area Variations in Health Care Delivery in Maryland, Health Services Research, Vol. 30, No. 2, pp. 295-317. McPherson, K., J. E. Wennberg., O. Hovind., and P. Clifford. (1982) Small-Area Variations in the Use of Common Surgical Procedures: An International Comparison of New 24
England, England, and Norway, The New England Journal of Medicine, Vol. 307, No. 21, pp. 1310-1314. Phelps, C. E. (2000) Information Diffusion and Best Practice Adoption, in A. J. Culyer and J. P. Newhouse, eds., Handbook of Health Economics, Vol. 1A, Ch.5, Amsterdam, Elsevier. (1997), Vol. 7, No. 3, pp. 53-82. (1998),. (1995),. (1997) 9,. (1983), Vol. 19, No. 1, pp. 56-69. 25