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Article 30-4

第三十条の四

The prefecture, with regard to basic policy, is to provide a plan (hereinafter referred to as "medical care plan") for ensuring the medical care delivery system in the relevant prefecture, in accordance with the actual conditions in the area.

都道府県は、基本方針に即して、かつ、地域の実情に応じて、当該都道府県における医療提供体制の確保を図るための計画(以下「医療計画」という。)を定めるものとする。

The following particulars are to be stipulated in the medical care plan:

医療計画においては、次に掲げる事項を定めるものとする。

particulars related to the activities set forth in item (iv) and item (v) and ensuring in-home medical care that should be achieved in the prefecture;

都道府県において達成すべき第四号及び第五号の事業並びに居宅等における医療の確保の目標に関する事項

particulars related to the medical care coordination system (meaning the system to ensure the sharing of functions between medical institutions and the coordination of operations; the same applies hereinafter) pertaining to activities as set forth in item (iv) and item (v) and ensuring in-home medical care;

第四号及び第五号の事業並びに居宅等における医療の確保に係る医療連携体制(医療提供施設相互間の機能の分担及び業務の連携を確保するための体制をいう。以下同じ。)に関する事項

particulars related to promoting the provision of information on functions of medical institutions under the medical care coordination system;

医療連携体制における医療提供施設の機能に関する情報の提供の推進に関する事項

particulars related to activities connected with treatment or prevention of illnesses prescribed by an Order of the Ministry of Health, Labour and Welfare as lifestyle diseases or other illnesses that are recognized as specifically requiring the provision of extensive and continuous medical care in order to ensure the health of the citizens;

生活習慣病その他の国民の健康の保持を図るために特に広範かつ継続的な医療の提供が必要と認められる疾病として厚生労働省令で定めるものの治療又は予防に係る事業に関する事項

particulars related to activities that are necessary for ensuring the following medical care (hereinafter referred to as "activities to ensure emergency medical care") (limited to where it is necessary to ensure this in the case of medical care listed in (d));

次に掲げる医療の確保に必要な事業(以下「救急医療等確保事業」という。)に関する事項(ニに掲げる医療については、その確保が必要な場合に限る。)

emergency medical care;

救急医療

medical care in times of disaster;

災害時における医療

medical care at times when an infectious disease whose spread is likely to have a serious impact on the lives and health of the citizens is spreading or there is a risk of its spreading;

そのまん延により国民の生命及び健康に重大な影響を与えるおそれがある感染症がまん延し、又はそのおそれがあるときにおける医療

medical care in remote areas;

へき地の医療

perinatal medical care;

周産期医療

pediatric medical care (including pediatric emergency medical care);

小児医療(小児救急医療を含む。)

beyond what is listed in (a) through (f), medical care that is recognized by the prefectural governor as being specifically necessary in the light of the status of outbreaks of illness, etc. in the relevant prefecture;

イからヘまでに掲げるもののほか、都道府県知事が当該都道府県における疾病の発生の状況等に照らして特に必要と認める医療

particulars related to ensuring in-home medical care;

居宅等における医療の確保に関する事項

particulars related to the vision of the future medical care delivery system including the following particulars (hereinafter referred to as "regional medical care vision") in the area specified in accordance with the standards set down by an Order of the Ministry of Health, Labour and Welfare as the standards for promoting the differentiation and coordination of bed functions in the region (hereinafter referred to as "vision area");

地域における病床の機能の分化及び連携を推進するための基準として厚生労働省令で定める基準に従い定める区域(以下「構想区域」という。)における次に掲げる事項を含む将来の医療提供体制に関する構想(以下「地域医療構想」という。)に関する事項

the future requirements for the number of beds for each functional classification of beds prescribed in Article 30-13, paragraph (1) (hereinafter simply referred to as the "future requirements for the number of beds") in the vision area calculated pursuant to an Order of the Ministry of Health, Labour and Welfare; and

構想区域における厚生労働省令で定めるところにより算定された第三十条の十三第一項に規定する病床の機能区分ごとの将来の病床数の必要量(以下単に「将来の病床数の必要量」という。)

beyond what is listed in (a), particulars specified by an Order of the Ministry of Health, Labour and Welfare as necessary for promoting the differentiation and coordination of the bed functions in the vision area;

イに掲げるもののほか、構想区域における病床の機能の分化及び連携の推進のために必要なものとして厚生労働省令で定める事項

particulars related to the promotion of the differentiation and coordination of bed functions to achieve the regional medical care vision;

地域医療構想の達成に向けた病床の機能の分化及び連携の推進に関する事項

particulars related to the promotion of the provision of information on bed functions;

病床の機能に関する情報の提供の推進に関する事項

particulars related to ensuring the medical care delivery system for outpatient medical care;

外来医療に係る医療提供体制の確保に関する事項

particulars related to ensuring the primary care function;

かかりつけ医機能の確保に関する事項

the following particulars related to ensuring the availability of physicians;

医師の確保に関する次に掲げる事項

the policy for ensuring the availability of physicians in the following areas (limited, in the case of the area listed in (2), to where its establishment is necessary);

次に掲げる区域における医師の確保の方針((2)に掲げる区域については、その設定が必要な場合に限る。)

the areas prescribed in items (xiv) and (xv); and

第十四号及び第十五号に規定する区域

the area established, with reference to the criteria established by the Minister of Health, Labour and Welfare, as an area in which it is necessary to focus on ensuring the availability of physicians;

重点的に医師の確保を図る必要がある区域として厚生労働大臣が定める基準を参酌して定める区域

the target of the number of physicians to be secured in the area prescribed in item (xiv) to be determined based on the indicator concerning the number of physicians in the relevant area calculated by the method specified by an Order of the Ministry of Health, Labour and Welfare;

厚生労働省令で定める方法により算定された第十四号に規定する区域における医師の数に関する指標を踏まえて定める同号に規定する区域において確保すべき医師の数の目標

the target number of physicians to be secured in the area prescribed in item (xv) to be determined based on the indicator concerning the number of physicians in the relevant area calculated by the method specified by an Order of the Ministry of Health, Labour and Welfare; and

厚生労働省令で定める方法により算定された第十五号に規定する区域における医師の数に関する指標を踏まえて定める同号に規定する区域において確保すべき医師の数の目標

the target number of physicians to be secured in the area listed in (a)(2) (limited to where that area has been established); and

イ(2)に掲げる区域において確保すべき医師の数の目標(当該区域を定めた場合に限る。)

measures for ensuring the availability of physicians, such as the dispatch of physicians, toward achieving the targets listed in (b) and (c), and measures for ensuring the availability of physicians, such as the dispatch of physicians, toward achieving the target listed in (d) (limited to where the area listed in (a)(2) has been established);

ロ及びハに掲げる目標の達成に向けた医師の派遣その他の医師の確保に関する施策並びにニに掲げる目標の達成に向けた医師の派遣その他の医師の確保に関する施策(イ(2)に掲げる区域を定めた場合に限る。)

particulars related to ensuring the availability of medical care professionals (excluding physicians);

医療従事者(医師を除く。)の確保に関する事項

particulars related to ensuring safety in medical care;

医療の安全の確保に関する事項

particulars related to the establishment of an area to be classified as a regional unit for the development of mainly beds in hospitals (excluding beds prescribed in the following item, psychiatric beds, infectious disease beds and tuberculosis beds) and beds in clinics;

主として病院の病床(次号に規定する病床並びに精神病床、感染症病床及び結核病床を除く。)及び診療所の病床の整備を図るべき地域的単位として区分する区域の設定に関する事項

particulars related to the establishment of an area that combines two or more areas prescribed in the preceding item as a regional unit for the development of mainly long-term care beds in hospitals that provide special medical care or general beds used for special medical care as specified by an Order of the Ministry of Health, Labour and Welfare;

二以上の前号に規定する区域を併せた区域であつて、主として厚生労働省令で定める特殊な医療を提供する病院の療養病床又は一般病床であつて当該医療に係るものの整備を図るべき地域的単位としての区域の設定に関する事項

in the event of the establishment of areas prescribed in paragraphs (6) and (7), particulars related to the establishment of the relevant areas; and

第六項及び第七項に規定する区域を定めた場合には、当該区域の設定に関する事項

particulars related to the target number of beds for long-term care beds and general beds, the target number of beds for psychiatric beds, the target number of beds for infectious disease beds, and the target number of beds for tuberculosis beds.

療養病床及び一般病床に係る基準病床数、精神病床に係る基準病床数、感染症病床に係る基準病床数並びに結核病床に係る基準病床数に関する事項

Beyond the particulars listed in each item of the preceding paragraph, efforts is to be made so that medical care plans stipulate the following particulars:

医療計画においては、前項各号に掲げる事項のほか、次に掲げる事項について定めるよう努めるものとする。

particulars related to targets for the development of regional medical care support hospitals and targets for the development of other medical institutions in consideration of the functions of such institutions; and

地域医療支援病院の整備の目標その他医療提供施設の機能を考慮した医療提供施設の整備の目標に関する事項

beyond what is listed in the preceding item, particulars necessary for securing the medical care delivery system.

前号に掲げるもののほか、医療提供体制の確保に関し必要な事項

The prefecture must consider the following particulars when stipulating particulars listed in paragraph (2) item (ii):

都道府県は、第二項第二号に掲げる事項を定めるに当たつては、次に掲げる事項に配慮しなければならない。

specific measures for the establishment of a medical care coordination system are to be specified for each disease prescribed by an Order of the Ministry of Health, Labour and Welfare set forth in item (iv) of paragraph (2) or medical care listed in (a) through (g) of item (v) of the same paragraph or in-home medical care;

医療連携体制の構築の具体的な方策について、第二項第四号の厚生労働省令で定める疾病又は同項第五号イからトまでに掲げる医療若しくは居宅等における医療ごとに定めること。

the details of the establishment of the medical care coordination system are to ensure that patients can receive appropriate medical care continuously even after being discharged from the hospital;

医療連携体制の構築の内容が、患者が退院後においても継続的に適切な医療を受けることができることを確保するものであること。

the details of the establishment of the medical care coordination system are to include the coordination between health and medical services and welfare services provided in medical institutions and in homes; and

医療連携体制の構築の内容が、医療提供施設及び居宅等において提供される保健医療サービスと福祉サービスとの連携を含むものであること。

the medical care coordination system is to be established through consultation among medical care professionals, long-term care service providers provided for in the Long-Term Care Insurance Act, citizens, and other related parties in the community.

医療連携体制が、医療従事者、介護保険法に規定する介護サービス事業者、住民その他の地域の関係者による協議を経て構築されること。

The prefecture, in stipulating particulars concerning the regional medical care vision, is to take into consideration the contents of reports under Article 30-13, paragraph (1), the prospects for changes in the demographic structure and other trends in demand for medical care, the prospects for the arrangement of medical care professionals and medical institutions, and other circumstances.

都道府県は、地域医療構想に関する事項を定めるに当たつては、第三十条の十三第一項の規定による報告の内容並びに人口構造の変化の見通しその他の医療の需要の動向並びに医療従事者及び医療提供施設の配置の状況の見通しその他の事情を勘案しなければならない。

In stipulating the particulars listed in paragraph (2), item (xi) (limited to those pertaining to the areas listed in (a)(1) of that item), the prefecture, for each type of medical care to be provided that is specified by an Order of the Ministry of Health, Labour and Welfare, may establish, in accordance with the standard specified by an Order of the Ministry of Health, Labour and Welfare concerning the indicator prescribed in paragraph (2) item (xi), (b), the area prescribed in item (xiv) of the same paragraph where the number of physicians is recognized to be small.

都道府県は、第二項第十一号に掲げる事項(同号イ(1)に掲げる区域に係るものに限る。)を定めるに当たつては、提供される医療の種別として厚生労働省令で定めるものごとに、同号ロに規定する指標に関し厚生労働省令で定める基準に従い、医師の数が少ないと認められる同項第十四号に規定する区域を定めることができる。

In stipulating the particulars listed in paragraph (2), item (xi) (limited to those pertaining to the areas listed in (a)(1) of that item), the prefecture, for each type of medical care to be provided that is specified by an Order of the Ministry of Health, Labour and Welfare, may establish, in accordance with the standard specified by an Order of the Ministry of Health, Labour and Welfare concerning the indicator prescribed in paragraph (2) item (xi), (b), the area prescribed in item (xiv) of the same paragraph where the number of physicians is recognized to be large.

都道府県は、第二項第十一号に掲げる事項(同号イ(1)に掲げる区域に係るものに限る。)を定めるに当たつては、提供される医療の種別として厚生労働省令で定めるものごとに、同号ロに規定する指標に関し厚生労働省令で定める基準に従い、医師の数が多いと認められる同項第十四号に規定する区域を定めることができる。

Standards related to the establishment of areas provided for in paragraph (2), items (xiv) and (xv), and the target number of beds provided for in item (xvii) of the same paragraph (for standards related to the target number of long-term care beds and general beds, standards based on the total number calculated according to each type of bed) are to be as prescribed by an Order of the Ministry of Health, Labour and Welfare.

第二項第十四号及び第十五号に規定する区域の設定並びに同項第十七号に規定する基準病床数に関する基準(療養病床及び一般病床に係る基準病床数に関する基準にあつては、それぞれの病床の種別に応じ算定した数の合計数を基にした基準)は、厚生労働省令で定める。

The prefecture, where it wishes to stipulate the target number of beds provided for in paragraph (2) item (xvii), when a sudden increase in population is expected or when there are other circumstances as provided by a Cabinet Order, may disregard the standards set forth in the preceding paragraph with regard to the target number of beds provided for in the same item, pursuant to the provisions of a Cabinet Order.

都道府県は、第二項第十七号に規定する基準病床数を定めようとする場合において、急激な人口の増加が見込まれることその他の政令で定める事情があるときは、政令で定めるところにより、同号に規定する基準病床数に関し、前項の基準によらないことができる。

After providing public notice of the medical care plan for a prefecture pursuant to provisions in paragraph (18), the relevant prefecture, when a sudden increase in population is expected, when an announcement concerning the outbreak, etc. of a pandemic influenza or similar infectious disease, etc. prescribed in has been made, or when there are other circumstances as provided by a Cabinet Order, may regard the target number of beds provided for in paragraph (2), item (xvii) as the number calculated pursuant to the provisions of a Cabinet Order, in areas as provided by Cabinet Order, and may engage in activities related to granting permission for applications for permission to establish hospitals and granting permission for other applications as prescribed by Cabinet Order.

都道府県は、第十八項の規定により当該都道府県の医療計画が公示された後に、急激な人口の増加が見込まれること、に規定する新型インフルエンザ等感染症等に係る発生等の公表が行われたことその他の政令で定める事情があるときは、政令で定めるところにより算定した数を、政令で定める区域の第二項第十七号に規定する基準病床数とみなして、病院の開設の許可の申請その他の政令で定める申請に対する許可に係る事務を行うことができる。

After providing public notice of the medical care plan for the prefecture pursuant to the provisions of paragraph (18), the relevant prefecture, where there has been an application for permission to establish a hospital that includes beds as prescribed by an Order of the Ministry of Health, Labour and Welfare, or where there has been another application as prescribed by a Cabinet Order, may regard the number calculated pursuant to the provisions of a Cabinet Order as the target number of beds provided for in paragraph (2), item (xvii) in areas as provided by Cabinet Order, and may engage in activities related to granting permission for the relevant application.

都道府県は、第十八項の規定により当該都道府県の医療計画が公示された後に、厚生労働省令で定める病床を含む病院の開設の許可の申請その他の政令で定める申請があつた場合においては、政令で定めるところにより算定した数を、政令で定める区域の第二項第十七号に規定する基準病床数とみなして、当該申請に対する許可に係る事務を行うことができる。

After providing public notice of the medical care plan for the prefecture pursuant to the provisions of paragraph (18), the relevant prefecture, where an application for permission to establish a hospital or any other application specified by a Cabinet Order has been filed by a participating corporation, etc. (meaning a participating corporation, etc. prescribed in Article 70, paragraph (1)) of a regional medical coordination promotion corporation and where it is found that the relevant application is necessary for promoting the achievement of the regional medical care vision specified in the relevant medical care plan and other requirements specified by an Order of the Ministry of Health, Labour and Welfare are met, may regard the number obtained by adding the number calculated pursuant to the provisions of a Cabinet Order to the target number of beds provided for in paragraph (2), item (xvii) in the relevant medical care plan pertaining to the relevant application as the relevant target number of beds, and may engage in activities related to granting permission for the relevant application.

都道府県は、第十八項の規定により当該都道府県の医療計画が公示された後に、地域医療連携推進法人の参加法人等(第七十条第一項に規定する参加法人等をいう。)から病院の開設の許可の申請その他の政令で定める申請があつた場合において、当該申請が当該医療計画において定める地域医療構想の達成を推進するために必要なものであることその他の厚生労働省令で定める要件に該当すると認めるときは、当該申請に係る当該医療計画において定められた第二項第十七号に規定する基準病床数に政令で定めるところにより算定した数を加えて得た数を、当該基準病床数とみなして、当該申請に対する許可に係る事務を行うことができる。

In preparing medical care plans, prefectures must ensure consistency with the prefectural plans prescribed in and the prefectural long-term care insurance business support plans prescribed in Article 118, paragraph (1) of the Long-Term Care Insurance Act, and with the prevention plans prescribed in and the prefectural action plans prescribed in .

都道府県は、医療計画を作成するに当たつては、に規定する都道府県計画及び介護保険法第百十八条第一項に規定する都道府県介護保険事業支援計画並びにに規定する予防計画及びに規定する都道府県行動計画との整合性の確保を図らなければならない。

In preparing medical care plans, prefectures are to endeavor to ensure that harmony is maintained with plans prepared pursuant to the provisions of other laws and regulations and with particulars that concern ensuring medical care, and must endeavor to seek coordination among public health, pharmacy, social welfare, and other measures which are closely related to medical care.

都道府県は、医療計画を作成するに当たつては、他の法律の規定による計画であつて医療の確保に関する事項を定めるものとの調和が保たれるようにするとともに、公衆衛生、薬事、社会福祉その他医療と密接な関連を有する施策との連携を図るように努めなければならない。

In preparing medical care plans, prefectures are to undertake liaison and coordination with related prefectures, when it is considered necessary in the light of the supply and demand of medical care in areas near the boundaries of the relevant prefectures.

都道府県は、医療計画を作成するに当たつて、当該都道府県の境界周辺の地域における医療の需給の実情に照らし必要があると認めるときは、関係都道府県と連絡調整を行うものとする。

The prefecture must hear the opinions of groups of persons with the relevant knowledge and experience in diagnoses or prescriptions, in order to prepare a draft medical care plan based on expert scientific opinions on medical care.

都道府県は、医療に関する専門的科学的知見に基づいて医療計画の案を作成するため、診療又は調剤に関する学識経験者の団体の意見を聴かなければならない。

The prefecture must hear the opinions of the Prefectural Council on Medical Service Facilities, municipalities (including a part of the administrative associations and cross-regional federations set forth in that handle first aid services), and the Council of Insurers set forth in Article 157-2, paragraph (1) of the Act on Assurance of Medical Care for Elderly People (Act No. 80 of 1982) in advance, when stipulating the medical care plan or revising the medical care plan pursuant to the provisions of Article 30-6.

都道府県は、医療計画を定め、又は第三十条の六の規定により医療計画を変更しようとするときは、あらかじめ、都道府県医療審議会、市町村(救急業務を処理するの一部事務組合及び広域連合を含む。)及び高齢者の医療の確保に関する法律(昭和五十七年法律第八十号)第百五十七条の二第一項の保険者協議会の意見を聴かなければならない。

When a prefecture has established a medical care plan or revised a medical care plan pursuant to the provisions of Article 30-6, it must submit the relevant plan to the Minister of Health, Labour and Welfare without delay and provide public notice of the details thereof.

都道府県は、医療計画を定め、又は第三十条の六の規定により医療計画を変更したときは、遅滞なく、これを厚生労働大臣に提出するとともに、その内容を公示しなければならない。

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