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

急性期や在宅の患者受け入れ、チーム医療に評価を―慢性期医療協会

日本慢性期医療協会(武久洋三会長)は7月16日、来年度の診療報酬改定に係る要望書を厚生労働省に提出した。要望では、医療療養病床で急性期病院の患者を受け入れた場合や、在宅で療養中の患者を急変時に受け入れた場合の加算、重症患者に対する加算やチーム医療への評価などを求めている。

　要望内容は大きく分けて、▽急性期との連携▽在宅との連携▽診療所との連携▽医療区分の重症加算▽医療区分の改善・維持の評価▽認知症▽チーム医療▽看護・介護の体制▽個室料▽一般病床の特定患者除外規定―など19項目。

　特に急性期との連携について、医療療養病床で急性期病院の患者を受け入れることが医療費の削減につながっているとして、急性期病院の患者を新規に受け入れた場合、「急性期受託加算」として、入院後1か月間は1日300点、2か月目は1日100点を認めるよう求めた。また、慢性期病院の医師や看護師が患者の転院促進のために急性期病院を訪問し、転院につながった場合の加算を要望。
　在宅との連携では、在宅や介護保険施設で療養中の患者の急変時に受け入れた場合の「在宅急変時受託加算」を認めるよう訴えた。診療所との連携では、在宅療養支援診療所の後方病床の役割を果たす地域の慢性期医療拠点に対する「支援病院加算」を認めるよう求めた。

　医療区分の重症加算では、医療区分3の各項目のうち3つ以上が合併している超重症患者に対する「超重症加算」など、重症患者に対する加算を要望。また、患者の医療区分の改善や維持に対する評価も求めた。

　チーム医療については、医療療養病床の入院患者の重症化に伴う職員の負担増を指摘した上で、一般病床で認められている医師事務作業補助体制加算を医療療養病床にも認めるよう要望。また、チーム医療の促進に伴い、多くのコメディカルが病棟業務に携わっているとして、薬剤師や管理栄養士、理学療法士、作業療法士、言語聴覚士、社会福祉士などの国家資格者の配置への評価を求めた。
 医療介護CBニュース

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