ケアサポート９／ケアマネージャー（介護支援専門員）試験／ＴＯＰへ

老人福祉・医療機関　倒産高止まり　競争激化　利用者の選別進む

老人福祉事業者と医療機関の倒産件数が高止まりしている。４～６月期の倒産は老人福祉事業者が１３件、医療機関は１９件に上ったことが８日、民間調査会社の帝国データバンクの調べで分かった。それぞれ過去最高となった２００８年度を上回るペースだ。競争の激化や、利用者の選択意識の高まりが背景にあるとみられる。医療・介護サービスの充実は福祉の観点から必要不可欠だが、市場原理とのバランスをいかにとるかが課題だ。

　今年度に入り、老人ホームや在宅介護サービスなど老人福祉事業者の倒産は、６月までの３カ月で、すでに０８年度の半分に達している。

　帝国データによると、倒産事例は、設立からあまり年数のたっていない、売上高１億円以下の地方の小規模事業者が多い。

　この傾向はここ数年顕著で、０８年度は倒産した事業者の約７割が、設立から倒産までの期間が「１０年未満」だった。００年の介護保険法施行で新規に参入する企業が増加したものの、競争の激化で入居率の低下を招き、その後の介護報酬の引き下げなどから、経営が行き詰まる事業者が相次いだ。

　ただ、４～６月の倒産について、帝国データは「特定の地域で営業する零細業者が多く、利用者への影響は限定的だろう」と分析する。

　一方、同じ４～６月の病院、診療所、歯科医院などの倒産も、過去最高の０８年度の半分に迫る１９件になった。内訳は、病床数２０以上の「病院」が４件、「診療所（クリニック）」が１０件、「歯科医院」が５件だった。

　診療所と歯科医院で倒産が目立つのは、診療所がこの７年間で５０００以上増え、患者の選択志向が強まったことが背景にある。診療所の増加は、休日や夜間に拘束される勤務医を敬遠し、収入が見込める診療所を開設する医師が増えているためだが、想定通りの収益を上げられず、倒産するケースも多いとみられる。

　病院の場合は、売り上げ減少の一方で、設備投資など過去の借り入れ負担がのしかかっている。診療報酬の引き下げや医師不足も加わって、経営に行き詰まる事業者が目立つ。

　帝国データでは、「景気悪化は、好調な審美歯科などにも影響し、医療法人の経営を圧迫する」と予想する。

　病院の減少は、病床不足につながる可能性もある。ただ、医療法人制度改革により、０８年３月期分からは医療法人の決算書が閲覧可能になったことから、「患者や取引業者が経営面も評価して医療機関を選択する傾向が強まるだろう。このため、倒産は増加する可能性がある」（情報部）と厳しく指摘する。（田村龍彦）（産経新聞）

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