་⒪⤒῭ホ౯䛾ᨻ⟇䜈䛾ᛂ⏝㻽㻻㻸ホ౯䛾⌧≧㻌 䡚ᨻ⟇ᛂ⏝䡚㻌䕿་⒪ᢏ⾡䛾㐍Ṍ䛻䜘䜚䚸⏕Ꮡᖺᩘ䛾ᘏ㛗䜔㻽㻻㻸䛾ྥୖ䛺䛹ከ䛟䛾䝯䝸䝑䝖䛜䜒䛯䜙䛥䜜䛶䛔䜛䚹㻌㻌䕿୍᪉䛷䚸་⒪ᢏ⾡䛾㐍Ṍ䛿་⒪㈝䛾ቑຍ䛻ᐤ୚䛧䛶䛔䜛䚹㻌㻌䕿බⓗ་⒪ಖ㞀ไᗘ䜢᭷䛩䜛ᅜ䛻䛚䛔䛶䛿䚸་⒪ᢏ⾡䛾⤒῭ホ౯䠄㈝⏝ᑐຠᯝ䛾ホ౯䠅䜢⾜䛔䚸䜹䝞䞊䛩䜛ᢏ⾡䜔ൾ㑏౯᱁タᐃ➼䛻཯ᫎ䛧䛶䛔䜛ᅜ䛜䛒䜛䚹㻌㻌 㻌 㻌 ౛䠅䜲䜼䝸䝇㻙㻺㻵㻯㻱䚸䜸䞊䝇䝖䝷䝸䜰㻙㻼㻮㻭㻯㻌㻌㻌་⒪䛻䛚䛡䜛㈝⏝ᑐຠᯝホ౯㻌➨㻝㻝ᅇ㻯㻿㻼㻙㻴㻻㻾ᖺ఍㻌㻞㻜㻝㻣㻚㻣㻚㻝㻌㻌ᅜ❧ಖ೺་⒪⛉Ꮫ㝔㻌⚟⏣㻌 ᩗ㻌㼠㻙㼒㼡㼗㼡㼐㼍㻬㼚㼕㼜㼔㻚㼓㼛㻚㼖㼜㻌

National Institute of Public Health, Japan1୰ኸ♫఍ಖ㝤་⒪༠㆟఍䠄୰་༠䠅㻌
ᖹᡂ24ᖺᗘデ⒪ሗ㓘ᨵᐃ䛻ಀ䜛⟅⏦᭩㝃ᖏពぢ2012.2.10

2୰་༠㈝⏝ᑐຠᯝホ౯ᑓ㛛㒊఍ᵓᡂ㻌㻌 䠍ྕ䠄ᨭᡶഃ䠅ጤဨ㻌䠒ྡ㻌㻌 䠎ྕ䠄デ⒪ഃ䠅ጤဨ㻌䠒ྡ㻌㻌 බ┈ጤဨ㻌䠐ྡ㻌㻌 ᑓ㛛ጤဨ㻌䠐ྡ㻌㻌 ཧ⪃ே㻌䠏ྡ㻌㻌ෆᐜ㻌㻌 ㈝⏝ᑐຠᯝ䛾ホ౯ᑐ㇟䚸ホ౯ᡭἲ䚸ホ౯⤖ᯝ䛾ά⏝᪉ἲ➼䛻䛴䛔䛶㆟ㄽ䛩䜛䚹㻌㻌఍ྜ䠄㻞㻜㻝㻣ᖺ㻢᭶㻝㻡᪥⌧ᅾ䠅㻌㻌 㻞㻜㻝㻞ᖺ㻡᭶㻞㻟᪥䠄➨䠍ᅇ䠅䡚㻞㻜㻝㻣ᖺ㻢᭶㻝㻠᪥䠄➨㻠㻜ᅇ䠅㻌㻌㻌䠍㻌䠓㻌㠉᪂ⓗ䛺᪂つ་⒪ᮦᩱ䜔䛭䛾ᮦᩱ䜢⏝䛔䜛᪂つᢏ⾡䚸㠉᪂ⓗ䛺་⸆ရ➼䛾ಖ㝤㐺⏝䛾ホ౯䛻㝿䛧䚸⟬ᐃ䝹䞊䝹䜔ᑂ㆟䛾䛒䜚᪉䜒ྵ䜑䚸㈝⏝ᑐຠᯝ䛾ほⅬ䜢ྍ⬟䛺⠊ᅖ䛷ᑟධ䛩䜛䛣䛸䛻䛴䛔䛶᳨ウ䜢⾜䛖䛣䛸䚹㻌㻌㻌

National Institute of Public Health, Japan

National Institute of Public Health, Japan

3

National Institute of Public Health, Japan4་⸆ရ䞉་⒪ᶵჾ䛾㈝⏝ᑐຠᯝホ౯䛾ヨ⾜ⓗᑟධ䠄ᖹᡂ28ᖺ4᭶䛛䜙䠅⤒῭㈈ᨻ㐠Ⴀ䛸ᨵ㠉䛾ᇶᮏ᪉㔪 2015
2015.6.30㻌 㛶㆟Ỵᐃ• ᑐ㇟䛸䛩䜛ရ┠㻌 㻌 㻌 ་⒪䛾㧗ᗘ໬䜈䛾ᑐᛂ䛸䛧䛶䚸་⸆ရ䜔་⒪ᶵჾ➼䛾ಖ䕧᪂つ䛻ಖ㝤཰㍕䛥䜜䜛ရ┠䕿᪤䛻ಖ㝤཰㍕䛥䜜䛶䛔䜛ရ┠㝤㐺⏝䛻㝿䛧䛶㈝⏝ᑐຠᯝ䜢⪃៖䛩䜛䛣䛸䛻䛴䛔䛶䚸ᖹᡂ㻞㻤ᖺᗘデ⒪ሗ㓘ᨵᐃ䛻䛚䛔䛶ヨ⾜ⓗ䛻ᑟධ䛧䛯ୖ䛷䚸㏿䜔䛛䛻ᮏ᱁ⓗ䛺ᑟධ䜢䛩䜛䛣䛸䜢┠ᣦ䛩䛸䜒䛻䚸⏕ά⩦័⑓἞⒪• ά⏝᪉ἲ⸆➼䛻䛴䛔䛶䚸㈝⏝㠃䜒ྵ䜑䛯ฎ᪉䛾ᅾ䜚᪉➼䛻䛴䛔䛶᳨㽢ಖ㝤ൾ㑏䛾ྍྰ䛾ุ᩿䕿ಖ㝤ൾ㑏౯᱁䜈䛾཯ᫎウ䛩䜛䚹㻌㻌

National Institute of Public Health, Japan

5

6

National Institute of Public Health, Japan᪤཰㍕ရ䛾㑅ᐃᇶ‽㈝⏝ᑐຠᯝホ౯䛾ヨ⾜ⓗᑟධ䛻㝿䛧䛶≉䛻᳨ウ䛜ᚲせ䛷䛒䛳䛯஦㡯㻌 䐟㝖እせ௳㻌 㻌 㻌 䜲㻌 ᣦᐃ㞴⑓䚸⾑཭⑓ཬ䜃HIVឤᰁ⑕㻌 㻌 㻌 䝻㻌 ᮍᢎㄆ⸆䞉㐺ᛂእ⸆᳨ウ఍㆟䜢㋃䜎䛘䛯㛤Ⓨせㄳ➼䠍䠊㈝⏝ᑐຠᯝホ౯䛻䛛䛛䜛᫬㛫㻌㻌 㻌 ㈝⏝ᑐຠᯝ䜢㐺ษ䛻ホ౯䛩䜛䛯䜑䛻䛿䛭䜜䛺䜚䛾᫬㛫䛜䛛䛛䜛䚹䛣䜜䛻䜘䜚ಖ㝤཰㍕䛜኱ᖜ䛻㐜䜜䜛䜘䛖䛺䛣䛸䛻䛺䜛䛸䚸᪂つ་⸆ရ䞉་⒪ᶵჾ䛾౑⏝䛜㐜䜜䛶䛧䜎䛖䚹㻌㻌 㻌 㻌 㻌 䊻᪤཰㍕ရ䛛䜙ྲྀ䜚⤌䜐㻌㻌䠎䠊㈝⏝ᑐຠᯝホ౯⤖ᯝ䛾ά⏝᪉ἲ㻌㻌 㻌 ㈝⏝ᑐຠᯝホ౯䛾⤖ᯝ䜢ಖ㝤ൾ㑏䛾ྍྰ䛾ุ᩿䛻⏝䛔䜛䛸䚸ಖ㝤ൾ㑏䛥䜜䛺䛔་⸆ရ䞉་⒪ᶵჾ䜢ᝈ⪅䛜฼⏝䛷䛝䛺䛟䛺䜛ྍ⬟ᛶ䛜䛒䜛䚹㻌㻌 㻌 㻌 㻌 䊻ཎ๎䛸䛧䛶䚸ಖ㝤ൾ㑏䛾ྍྰ䛷䛿䛺䛟䚸ಖ㝤ൾ㑏౯᱁䜈䛾཯ᫎ䛻⏝䛔䜛㻌㻌㻌 䐠ᢳฟせ௳㻌 㻌 㻌 䜲㻌 ᖹᡂ24ᖺᗘ䛛䜙ᖹᡂ27ᖺᗘ䚸䛛䛴䚸㢮ఝ⸆ຠẚ㍑᪉ᘧཪ䛿㢮ఝᶵ⬟༊ศẚ
㍑᪉ᘧ䛾䛖䛱㻌 㻌 㻌 㻌 㻌 㻌 i㻌 ⿵ṇຍ⟬䛾ຍ⟬⋡䛜᭱㧗㻌 㻌 㻌 㻌 㻌 㻌 ii㻌 10%௨ୖ䛾⿵ṇຍ⟬䛜ㄆ䜑䜙䜜䛯䜒䛾䛾୰䛷䚸་⸆ရ䛻䛴䛔䛶䛿䝢䞊䜽᫬ண ኎ୖ㧗䛜᭱㧗䚸་⒪ᶵჾ䛻䛴䛔䛶䛿ಖ㝤ൾ㑏౯᱁䛜᭱㧗㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 ͤ㻌 i䛸ii䛾ヱᙜရ┠䛜୍⮴䛩䜛ሙྜ䛿1ရ┠䛸䛺䜛䚹㻌 㻌 㻌 䝻㻌 ᖹᡂ24ᖺᗘ䛛䜙ᖹᡂ27ᖺᗘ䚸䛛䛴䚸ཎ౯ィ⟬᪉ᘧ䛾䛖䛱䚸㻌 㻌 㻌 㻌 㻌 㻌 i㻌 Ⴀᴗ฼┈⋡䛾ຍ⟬⋡䛜᭱㧗㻌 㻌 㻌 㻌 㻌 㻌 ii㻌 10%௨ୖ䛾ຍ⟬䛜ㄆ䜑䜙䜜䛯䜒䛾䛾୰䛷䚸་⸆ရ䛻䛴䛔䛶䛿䝢䞊䜽᫬ண኎ୖ㧗䛜᭱㧗䚸་⒪ᶵჾ䛻䛴䛔䛶䛿ಖ㝤ൾ㑏౯᱁䛜᭱㧗㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 ͤ㻌 i䛸ii䛾ヱᙜရ┠䛜୍⮴䛩䜛ሙྜ䛿1ရ┠䛸䛺䜛䚹㻌 ͤ䛣䜜䛻䜘䛳䛶㑅ᐃ䛥䜜䛯ရ┠䛾⸆⌮స⏝㢮ఝ⸆䚸ྠ୍ᶵ⬟༊ศ䛻ヱᙜ䛩䜛་⒪ᶵ
ჾ䜒ᑐ㇟㻌 䈜ᑐ㇟ရ┠௨እ䛷䜒௵ព䛷䝕䞊䝍ᥦฟྍ㻌

National Institute of Public Health, Japan

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National Institute of Public Health, Japan䠄➨㻟㻟ᅇ㈝⏝ᑐຠᯝホ౯ᑓ㛛㒊఍㻔㻴㻞㻤㻚㻝㻚㻞㻜㻕㈨ᩱ䜘䜚䠅㻌
8᪤཰㍕ရ䛾ᑐ㇟ရ┠་⸆ရ䠄䠓ရ┠䠅㻌㻌 䠷㢮ఝ⸆ຠẚ㍑᪉ᘧ䠖䠑ရ┠䠹㻌㻌 㻌 䝋䝞䝹䝕䜱䠄䜼䝸䜰䝗䞉䝃䜲䜶䞁䝅䝈䠅㻌㻌 㻌 䝝䞊䝪䝙䞊䠄䜼䝸䜰䝗䞉䝃䜲䜶䞁䝅䝈䠅㻌㻌 㻌 䞂䜱䜻䝷䝑䜽䝇䠄䜰䝑䞂䜱䠅㻌㻌 㻌 䝎䜽䝹䜲䞁䝄䠄䝤䝸䝇䝖䝹䞉䝬䜲䝲䞊䝈䠅㻌㻌 㻌 䝇䞁䝧䝥䝷䠄䝤䝸䝇䝖䝹䞉䝬䜲䝲䞊䝈䠅㻌㻌㻌 䠷ཎ౯ィ⟬᪉ᘧ䠖䠎ရ┠䠹㻌㻌 㻌 䜸䝥䝆䞊䝪䠄ᑠ㔝⸆ရᕤᴗ䠅㻌㻌 㻌 䜹䝗䝃䜲䝷䠄୰እ〇⸆䠅㻌㻌་⒪ᶵჾ䠄䠒ရ┠䠅㻌㻌 䠷㢮ఝᶵ⬟༊ศẚ㍑᪉ᘧ䠖䠐ရ┠䠹㻌㻌 㻌 䜹䝽䝇䝭㻺㼍㼖㼡㼠㼍⬚㒊䝇䝔䞁䝖䜾䝷䝣䝖䝅䝇䝔䝮㻌㻌 㻌 㻌 㻌 䠄ᕝ⃈໬Ꮫᕤᴗ䠅㻌㻌 㻌 䜰䜽䝔䜱䝞㻾㻯䠄᪥ᮏ䝯䝗䝖䝻䝙䝑䜽䠅㻌㻌 㻌 䝞䞊䝃䜲䝇㻰㻮㻿䝅䝇䝔䝮㻌㻌 㻌 㻌 㻌 䠄䝪䝇䝖䞁䞉䝃䜲䜶䞁䝔䜱䝣䜱䝑䜽䞉䝆䝱䝟䞁䠅㻌㻌 㻌 㻮㼞㼕㼛㻌㻰㼡㼍㼘㻤㻌䝙䝳䞊䝻䝇䝔䜱䝭䝳䝺䞊䝍㻌㻌 㻌 㻌 㻌 䠄䝉䞁䝖䞉䝆䝳䞊䝗䞉䝯䝕䜱䜹䝹䠅㻌㻌㻌 䠷ཎ౯ィ⟬᪉ᘧ䠖䠎ရ┠䠹㻌㻌 㻌 䝆䝱䝑䜽䠄䝆䝱䝟䞁䞉䝔䜱䝑䝅䝳䞉䜶䞁䝆䝙䜰䝸䞁䜾䠅㻌㻌 㻌 䝃䝢䜶䞁㼄㼀䠄䜶䝗䝽䞊䝈䝷䜲䝣䝃䜲䜶䞁䝇䠅㻌᪂つ཰㍕ရ䛾㑅ᐃᇶ‽㻌 䐟㝖እせ௳㻯ᆺ៏ᛶ⫢⅖㻌㻯ᆺ៏ᛶ⫢⅖㻌㻯ᆺ៏ᛶ⫢⅖㻌㻯ᆺ៏ᛶ⫢⅖㻌㻯ᆺ៏ᛶ⫢⅖㻌㻌 㻌 㻌 䜲㻌 ᣦᐃ㞴⑓䚸⾑཭⑓ཬ䜃HIVឤᰁ⑕㻌 㻌 㻌 䝻㻌 ᮍᢎㄆ⸆䞉㐺ᛂእ⸆᳨ウ఍㆟䜢㋃䜎䛘䛯㛤Ⓨせㄳ➼㻌 䐠ᢳฟせ௳ᝏᛶ㯮Ⰽ⭘➼㻌㻴㻱㻾㻞㝧ᛶ䛾෌Ⓨங⒴➼㻌㻌 㻌 㻌 䜲㻌 㢮ఝ⸆ຠẚ㍑᪉ᘧཪ䛿㢮ఝᶵ⬟༊ศẚ㍑᪉ᘧ䛷䚸10%௨ୖ䛾⿵ṇຍ⟬䜢ᕼᮃ䚸䛛䛴䚸䝢䞊䜽᫬ண ኎ୖ㧗䛜୍ᐃ㔠㢠䠄་⸆ရ500൨෇䚸་⒪ᶵჾ50൨෇䠅௨ୖ㻌 㻌 㻌 䝻㻌 ཎ౯ィ⟬᪉ᘧ䛷䚸10%௨ୖ䛾Ⴀᴗ฼┈⋡䛾ຍ⟬䜢ᕼᮃ䚸䛛䛴䚸䝢䞊䜽᫬ண኎ୖ㧗䛜୍ᐃ㔠㢠䠄་⸆ရ100൨෇䚸་⒪ᶵჾ10൨෇䠅௨ୖ㻌 䈜ᑐ㇟ရ┠௨እ䛷䜒௵ព䛷䝕䞊䝍ᥦฟྍ㻌⬚㒊኱ື⬦⒗㻌᣺ᡓ➼㻌᣺ᡓ➼㻌

ͤ2016ᖺ10᭶௨㝆䛻ಖ㝤㐺⏝ᕼᮃ᭩䛜ᥦฟ䛥䜜䜛䜒䛾䛻䛴䛔䛶ᑐ㇟䛸䛩䜛䚹ͤホ౯䛾䛯䜑䛾యไ➼䛾ᩚഛ䛜༑ศ䛷䛺䛔ヨ⾜ⓗᑟධ䛾ẁ㝵䛷䛿䚸㈝⏝ᑐຠᯝホ౯ᑓ㛛⤌⧊䛻䜘䜛ホ౯䛜䚸᪂つ཰㍕ရ䛾ಖ㝤཰㍕䛻㛫䛻ྜ䜟䛺䛔䛸⪃䛘䜙䜜䜛䛣䛸䛛䜙䚸ヨ⾜ⓗᑟධ䛾㝿䛻䛿䚸᪂つ཰㍕ရ䛻ಀ䜛ホ౯⤖ᯝ䜢౯᱁⟬ᐃ䛻⏝䛔䛺䛔䚹᣺ᡓ➼㻌

እയᛶ㌾㦵Ḟᦆ⑕㻌㔜ᗘ኱ື⬦ᘚ⊃✽⑕㻌䠄୰་༠⥲఍㻌㻔㻴㻞㻤㻚㻣㻚㻞㻣㻕㈨ᩱ䜘䜚సᡂ䠅㻌
9National Institute of Public Health, Japanᝲဇ‫ݣ‬јௐᚸ̖ỉɟᡲỉ්ủᴾ䠄➨㻟㻟ᅇ㈝⏝ᑐຠᯝホ౯ᑓ㛛㒊఍㻔㻴㻞㻤㻚㻝㻚㻞㻜㻕䚸➨㻟䠐ᅇ㈝⏝ᑐຠᯝホ౯ᑓ㛛㒊఍㻔㻴㻞㻤㻚㻠㻚㻞㻣㻕㈨ᩱ䜘䜚సᡂ䠅㻌
National Institute of Public Health, Japan10௻ᴗ䛻䜘䜛䝕䞊䝍ᥦฟ‫ݣ‬ᝋԼႸᢠ‫ܭ‬ᴾᝲဇ‫ݣ‬јௐᚸ̖‫ᧉݦ‬ᢿ˟ỆấẟềẆ‫ݣ‬ᝋԼႸỉᢠ‫ؕܭ‬แửᚨ‫ܭ‬ẴỦẇᚨ‫ܭ‬ẰủẺؕแỆؕỀẨẆԼႸỉᢠ‫ܭ‬ửᘍạẇᴾἙὊἑ੩Јᴾ‫ݣ‬ᝋԼႸỉᙌᡯᝤ٥ಅᎍỊẐɶ‫ځ‬ᅈ˟̬ᨖҔၲңᜭ˟ỆấẬỦᝲဇ‫ݣ‬јௐᚸ̖ỉЎௌỾỶἛἻỶὅẑỆؕỀẨᝲဇјௐЎௌửܱ଀ẲẆἙὊἑử੩ЈẴỦẇᴾЎௌử᧏‫ڼ‬ẴỦЭỆЎௌ৖ඥሁỆếẟềʙЭႻᛩửᘍạẇᴾϐЎௌỉܱ଀ᴾπႎễ‫˳ᧉݦ‬СỆợụɶᇌႎễᇌ‫ئ‬ẦỤϐЎௌửܱ଀ẴỦẇᴾπႎễ‫˳ᧉݦ‬СểᡲઃẲẺ‫ٳ‬ᢿỉ‫ܼᧉݦ‬ỤίϐЎௌἂἽὊἩὸầɼểẲềਃ࢘Ẵ
Ủẇᴾዮӳႎᚸ̖ᴾίỴἩἾỶἈἽὸᴾᙌᡯᝤ٥ಅᎍӏỎϐЎௌἂἽὊἩỆợụᅆẰủẺ‫ف‬ЎᝲဇјௐൔίᵧᵡᵣᵰὸሁỉЎௌኽௐử៊ộảẆᝲဇ‫ݣ‬јௐᚸ̖‫ᧉݦ‬ኵጢỉ‫ᧉݦ‬ႎᙸ‫ע‬ẦỤỉዮӳႎᚸ̖ửኺềẆᚸ̖ኽௐకửሊ‫ܭ‬ẴỦẇᴾ䐟㑅ᐃᇶ‽䛻ᇶ䛵䛝㑅ᐃ䛥䜜䛯ᑐ㇟ရ┠䛻䛴䛔䛶䚸〇㐀㈍኎ᴗ⪅䛿䚸䛂୰ኸ♫఍ಖ㝤་⒪༠㆟఍䛻䛚䛡䜛㈝⏝ᑐຠᯝホ౯䛾ศᯒ䜺䜲䝗䝷䜲䞁䛃䛻ᇶ䛵䛝ศᯒ䜢ᐇ᪋䛧䚸ศᯒ᪉ἲ䚸᮲௳ཬ䜃ศᯒ⤖ᯝ䜢♧䛩䝕䞊䝍䜢ᥦฟ䠄௵ព䛷䛾ᥦฟ䜒ྍ䠅㻌㻌䐠ศᯒ䜢㛤ጞ䛩䜛๓䛻䚸ศᯒᡭἲ➼䛻䛴䛔䛶஦๓┦ㄯ䜢ᐇ᪋㻌㻌䐡䜺䜲䝗䝷䜲䞁䛻ᇶ䛵䛟ᶆ‽ⓗ䛺ศᯒ᪉ἲ௨እ䛾ศᯒ᪉ἲ䜢ྲྀ䜛ሙྜ➼䛻䛿䚸ᚲせ䛻ᛂ䛨䛶䚸㈝⏝ᑐຠᯝホ౯ᑓ㛛⤌⧊䛻䛚䛔䛶ศᯒ᪉ἲ➼䛾ጇᙜᛶ➼䛻䛴䛔䛶ண䜑☜ㄆ㻌㻌䠄୰་༠⥲఍㻌㻔㻴㻞㻤㻚㻞㻚㻝㻜㻕㈨ᩱ䜘䜚సᡂ䠅㻌
National Institute of Public Health, Japan

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National Institute of Public Health, Japan12୰ኸ♫఍ಖ㝤་⒪༠㆟఍䛻䛚䛡䜛㈝⏝ᑐຠᯝホ౯䛾ศᯒ䜺䜲䝗䝷䜲䞁䠔䠊ຠᯝᣦᶆ䛾㑅ᢥ㻝㻚㻌䜺䜲䝗䝷䜲䞁䛾┠ⓗ㻌㻌 㻌 ୰་༠䛻䛚䛡䜛㈝⏝ᑐຠᯝホ౯䜢ᐇ᪋䛩䜛䛻䛒䛯䛳䛶⏝䛔䜛ศᯒ᪉ἲ䚹㻌㻞㻚㻌ศᯒ䛾❧ሙ㻌㻌 㻌 䛂බⓗ་⒪䛾❧ሙ䛃䜢᥎ዡ䚹䛂බⓗ་⒪䞉௓ㆤ䛾❧ሙ䛃䚸䜘䜚ᗈ⠊䛺㈝⏝䜢⪃៖䛩䜛❧ሙ䛛䜙䛾ศᯒ䜒ྍ䚹㻌㻟㻚㻌ศᯒᑐ㇟㞟ᅋ㻌㻌 㻌 ホ౯ᑐ㇟ᢏ⾡䛾㐺ᛂ䛸䛺䜛ᝈ⪅䚹」ᩘ䛾㞟ᅋ䜔౑⏝ἲ䛾ሙྜ䛿䛭䜜䛮䜜ศᯒ䜢ᐇ᪋䚹㻌㻟㻚㻌ẚ㍑ᑐ↷ᢏ⾡㻌㻌 㻌 ᙜヱᢏ⾡䛜ᑟධ䛥䜜䛯᫬Ⅼ䛷ከ䛟௦᭰䛥䜜䛯䛸᝿ᐃ䛥䜜䜛䜒䛾䚹㻌㻡㻚㻌㏣ຍⓗ᭷ຠᛶ䞉Ᏻ඲ᛶ㻌㻌 㻌 ẚ㍑ᑐ↷䛻ᑐ䛧䛶㏣ຍⓗ䛺᭷ຠᛶ䡡Ᏻ඲ᛶ䜢ホ౯䚹᭱᪂᫬Ⅼ䜎䛷䛾ẚ㍑ヨ㦂䛾䝅䝇䝔䝬䝔䜱䝑䜽䝺䝡䝳䞊䜢ᐇ᪋䚹㻌㻢㻚㻌ศᯒᡭἲ㻌㻌 㻌 ㈝⏝ຠᯝศᯒ䜢⏝䛔䚸⤖ᯝ䛿ቑศ㈝⏝ຠᯝẚ䛷⾲䛩䚹㻌㻣㻚㻌ศᯒᮇ㛫㻌㻌 㻌 ༑ศ㛗䛔ศᯒᮇ㛫䚹㻌㻤㻚㻌ຠᯝᣦᶆ䛾㑅ᢥ㻌㻌 㻌 㻽㻭㻸㼅䜢ᇶᮏ䛸䛧䛴䛴䚸⑌ᝈ䜔་⸆ရ䞉་⒪ᶵჾ➼䛾≉ᛶ䛻ᛂ䛨䛶䚸䛭䛾௚䛾ᣦᶆ䜒฼⏝ྍ䚹㻌㻌㻥㻚㻌䝕䞊䝍䝋䞊䝇㻌㻌 㻌 䜶䝡䝕䞁䝇䝺䝧䝹䛜㧗䛟䚸䛛䛴⌧ᐇ䛾⮫ᗋᡂ⦼䜢཯ᫎ䛧䛶䛔䜛䜒䛾䜢ඃඛⓗ䛻౑⏝䚹㻌㻝㻜㻚㻌㈝⏝䛾⟬ฟ㻌㻌 㻌 ༢౯䛿デ⒪ሗ㓘Ⅼᩘ䚸ᾘ㈝㔞䛿ᶆ‽ⓗ䛺デ⒪㐣⛬䜢཯ᫎ䛧䛯䜒䛾䚹㻌㻝㻝㻚㻌බⓗ௓ㆤ㈝⏝䞉⏕⏘ᛶᦆኻ䛾ྲྀ䜚ᢅ䛔㻌㻌 㻌 ศᯒ䛾❧ሙ䛻䜘䜚㈝⏝䛻ྵ䜑䜛䛣䛸䛿ྍ䚹㻌㻝㻞㻚㻌๭ᘬ㻌㻌 㻌 ㈝⏝䞉ຠᯝ䛸䜒ᖺ⋡㻞㻑䛷๭䜚ᘬ䛟䚹㻌㻝㻟㻚㻌䝰䝕䝹ศᯒ㻌㻌 㻌 䝰䝕䝹ศᯒ䛿ྍ䚸ጇᙜᛶ䛾᳨ド䛜ᚲせ䚹㻌㻝㻠㻚㻌୙☜ᐇᛶ䛾ྲྀ䜚ᢅ䛔㻌㻌 㻌 ឤᗘศᯒ䛾ᐇ᪋䚹㻌㻝㻡㻚㻌ሗ࿌䞉බ㛤᪉ἲ㻌㻌 㻌 ሗ࿌ᵝᘧ䚹ศᯒ⤖ᯝ䛿ཎ๎බ㛤䚹㻌䠄➨㻟㻟ᅇ㈝⏝ᑐຠᯝホ౯ᑓ㛛㒊఍㻔㻴㻞㻤㻚㻝㻚㻞㻜㻕㈨ᩱ䜘䜚䠅㻌
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National Institute of Public Health, Japanὀ䠅QALY䜢⟬ฟ䛩䜛㝿䛾QOL್䛾National Institute of Public Health, Japan14

䠔䠊ຠᯝᣦᶆ䛾㑅ᢥᐃ㻌 㻌 㻤㻚㻞㻚㻞㻌䛂㻤㻚㻞䛃䛻ヱᙜ䛩䜛䝕䞊䝍䛜Ꮡᅾ䛧䛺䛔ሙྜ䚸䛭䛾௚䛾㐺ษ䛺ᝈ⪅ሗ࿌䜰䜴䝖䜹䝮㻔㻼㻾㻻㻕䛛䜙㻽㻻㻸್䜈䝬䝑䝢䞁䜾䛧䛯䜒䛾䜢౑⏝䛧䛶䜒䜘䛔䚹䝬䝑䝢䞁䜾䛻䜘䜚ᚓ䜙䜜䛯್䜢౑⏝䛩䜛ሙྜ䚸㐺ษ䛺ᡭἲ䜢⏝䛔䛶㻽㻻㻸್䛻ኚ᥮䛧䛶䛔䜛䛣䛸䜢ㄝ᫂䛩䜛䛣䛸䚹㻌㻌㻤㻚㻟㻌㻽㻻㻸್䜢 ᐃ䛩䜛ሙྜ䛻䛿䚸ᑐ㇟⪅ᮏே䛜ᅇ⟅䛩䜛䛣䛸䛜ཎ๎䛷䛒䜛䚹㻌㻌㻌㻌 㻌 㻤㻚㻟㻚㻝㻌ᑐ㇟⪅ᮏே䛛䜙㻽㻻㻸್䛜ᚓ䜙䜜䛺䛔ሙྜ䛻㝈䜚䚸ᐙ᪘䜔௓ㆤ⪅➼䛻䜘䜛௦⌮䛾ᅇ⟅䜢⏝䛔䛶䜒䜘䛔䚹㻌㻌㻌 㻌 㻤㻚㻟㻚㻞㻌་⒪㛵ಀ⪅䛻䜘䜛௦⌮ᅇ⟅䛿䚸ᑐ㇟⪅ᮏே䛾ᅇ⟅䛸஋㞳䛩䜛ྍ⬟ᛶ䛜䛒䜛䛾䛷䚸䛭䛾Ⅼ䛻䛴䛔䛶⪃ᐹ䜢⾜䛖䛣䛸䚹㻌㻌㻤㻚㻠㻌㻽㻻㻸್䛿䚸䛂㻤㻚㻞䛃䛚䜘䜃䛂㻤㻚㻟䛃䜢‶䛯䛩䜒䛾䛜䛒䜛㝈䜚䚸ᅜෆ䛷䛾ㄪᰝ⤖ᯝ䜢ඃඛⓗ䛻౑⏝䛩䜛䛣䛸䜢᥎ዡ䛩䜛䚹㻌㻌㻌㻌 㻌 㻤㻚㻠㻚㻝㻌䛯䛰䛧䚸ᅜෆ䛻䛚䛡䜛◊✲䛜䛺䛔䛒䜛䛔䛿୙༑ศ䛷䚸ᾏእ䛷㉁䛾㧗䛔
◊✲䛜䛺䛥䜜䛶䛔䜛ሙྜ䛿䚸ᾏእ䛷 ᐃ䛥䜜䛯䜒䛾䜢౑⏝䛧䛶䜒䜘䛔䚹㻌㻌┤᥋ἲ㻌㻌 ௬᝿ⓗ䛺㻔䛒䜛䛔䛿ᮏே䛾㻕೺ᗣ≧ែ䛻ᑐ䛧䛶䚸䛭䛾≧ែ䛾㻽㻻㻸್䜢୍⯡䛾ே䚻䜢ᑐ㇟䛻㉁ၥ䛩䜛᪉ἲ䚹㻌㻌 䞉ᇶ‽ⓗ㉃䛡㻔㻿㼠㼍㼚㼐㼍㼞㼐㻌㼓㼍㼙㼎㼘㼑㻦㻌㻿㻳㻕ἲ㻌㻌 䞉᫬㛫ᚓኻ㻔㼀㼕㼙㼑㻌㼠㼞㼍㼐㼑㻙㼛㼒㼒㻦㻌㼀㼀㻻㻕ἲ㻌 㻌 㻌 㻌 㻌 䛺䛹㻌㻌㛫᥋ἲ㻌㻌 㻽㻻㻸㉁ၥ⚊䛻䜘䜚ᚓ䜙䜜䛯ᅇ⟅䛛䜙䝇䝁䜰䝸䞁䜾䜰䝹䝂䝸䝈䝮䜢⏝䛔䛶㻽㻻㻸್䜢⟬ฟ䛩䜛᪉ἲ䚹㻌㻌 䞉㻱㻽㻙㻡㻰㻔㻱㼡㼞㼛㻽㼛㼘㻌㻡㻌㻰㼕㼙㼑㼚㼟㼕㼛㼚㻕㻌㻌 䞉㻿㻲㻙㻢㻰㻔㻿㼔㼛㼞㼠㻌㻲㼛㼞㼙㻌㻢㻌㻰㼕㼙㼑㼚㼟㼕㼛㼚㻕㻌㻌 䞉㻴㼁㻵㻔㻴㼑㼍㼘㼠㼔㻌㼁㼠㼕㼘㼕㼠㼕㼑㼟㻌㻵㼚㼐㼑㼤㻕㻌 㻌 㻌 㻌 䛺䛹㻌
National Institute of Public Health, Japan㻤㻚㻝㻌ຠᯝᣦᶆ䛿㉁ㄪᩚ⏕Ꮡᖺ㻔㻽㼡㼍㼘㼕㼠㼥㻙㼍㼐㼖㼡㼟㼠㼑㼐㻌㼘㼕㼒㼑㻌㼥㼑㼍㼞㻘㻌㻽㻭㻸㼅㻕㻌䜢ᇶᮏ䛸䛧䛴䛴䚸⑌ᝈ䜔་⸆ရ䞉་⒪ᶵჾ➼䛾≉ᛶ➼䛻ᛂ䛨䛶䚸䛭䛾௚䛾ᣦᶆ䜒⏝䛔䜛䛣䛸䛜䛷䛝䜛䚹㻌㻌㻌 㻌 㻤㻚㻝㻚㻝㻌㻽㻭㻸㼅䜢౑⏝䛩䜛ሙྜ䚸⏕Ꮡᮇ㛫䛻ᙳ㡪䜢ཬ䜌䛩་⒪ᢏ⾡䛻䛴䛔䛶䛿䚸⏕Ꮡᖺ㻔㻸㼅㻕䛷䛾ホ౯䜒䛒䜟䛫䛶ᥦ♧䛩䜛䛣䛸䚹㻌㻌㻌 㻌 㻤㻚㻝㻚㻞ຠᯝᣦᶆ䛾㑅ᐃ䛻ᙜ䛯䛳䛶䚸㻽㻭㻸㼅䜢౑⏝䛧䛺䛔ሙྜ䛿䚸་⸆ရ䞉་⒪ᶵჾ➼䛾≉ᛶ➼䜢㋃䜎䛘䛶᳨ウ䛩䜛ᚲせ䛜䛒䜛䛣䛸䛛䜙䚸஦๓䛻༠㆟䜢⾜䛳䛶᳨ウ䛩䜛䛣䛸䜢ཎ๎䛸䛩䜛䚹㻌㻌㻤㻚㻞㻌㻽㻭㻸㼅䜢⟬ฟ䛩䜛㝿䛾㻽㻻㻸್䛿䚸୍⯡䛾ே䚻䛾౯್䜢཯ᫎ䛷䛝䜛᪉ἲ㻔㻱㻽㻙㻡㻰㻘㻿㻲㻙㻢㻰㻘㻌㻴㼁㻵㻌➼䛾㉁ၥ⣬ἲ䚸ᇶ‽ⓗ㉃䛡㻔㻿㼠㼍㼚㼐㼍㼞㼐㻌㼓㼍㼙㼎㼘㼑㻦㻌㻿㻳㻕ἲ䚸᫬㛫ᚓኻ㻔㼀㼕㼙㼑㻌㼠㼞㼍㼐㼑㻙㼛㼒㼒㻦㻌㼀㼀㻻㻕ἲ䛺䛹㻕䜢⏝䛔䜛䚹㻌㻌㻌㻌 㻌 㻤㻚㻞㻚㻝㻌㈝⏝ຠᯝศᯒ䜢⾜䛖䛯䜑䛻䚸᪂䛯䛻᪥ᮏᅜෆ䛷㻽㻻㻸್䜢཰㞟䛩䜛㝿䛻䛿䚸ᅜෆ䝕䞊䝍䛻ᇶ䛵䛝㛤Ⓨ䛥䜜䛯䝇䝁䜰䝸䞁䜾䜰䝹䝂䝸䝈䝮䜢᭷䛩䜛ᑻᗘ䜢౑⏝䛩䜛䛣䛸䜢᥎ዡ䛩䜛䚹㻌

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National Institute of Public Health, Japan16෌ศᯒ䛾ᐇ᪋

EQ-5D䛾䝞䝸䜶䞊䝅䝵䞁䐟௻ᴗ䛜ᥦฟ䛧䛯䝕䞊䝍䛻䛴䛔䛶䚸බⓗ䛺ᑓ㛛యไ䛻䜘䜚୰❧ⓗ䛺❧ሙ䛛䜙෌ศᯒ䜢ᐇ᪋䛩䜛䛣䛸䛸䛩䜛䚹෌ศᯒ䛾ᐇ᪋䛻ᙜ䛯䛳䛶䛿䚸බⓗ䛺ᑓ㛛యไ䛸㐃ᦠ䛧䛯እ㒊䛾ᑓ㛛ᐙ䜙䛜୺䛸䛧䛶෌ศᯒ䜢ᐇ᪋㻌䐠෌ศᯒ䛾ᐇ᪋䛻ᙜ䛯䛳䛶䛿䚸฼┈┦཯䛻㛵䛩䜛つᐃ䜢ᐃ䜑䚸෌ศᯒ䜾䝹䞊䝥䛾ᵓᡂဨ䛿䚸䛣䛾つᐃ䛻ᚑ䛳䛶෌ศᯒ䛾ᐇ᪋䛻ཧຍ㻌㻌

䞉EQ-5D-3L㻌 䠑ḟඖ䠏ẁ㝵䛾ᅇ⟅䛻䜘䜛㉁ၥ⚊䞉EQ-5D-5L㻌 ᅇ⟅䜢䠑ẁ㝵䛻ቑ䜔䛧䛯䝞䞊䝆䝵䞁
䞉EQ-5D-Y㻌 㻌 EQ-5D-3L䜢ᑠඣྥ䛡䛻⾲⌧䜢ᨵ䜑䛯䝞䞊䝆䝵䞁ᾋϐЎௌỉỶἳὊἊᾍᴾཌ⏕ປാ┬኱Ꮫ䠝

䞉EQ-5D-5L-Proxy㻌 㻌 EQ-5D-5L䜢௦⌮ᅇ⟅⪅䛜グ㍕䛩䜛䝞䞊䝆䝵䞁኱Ꮫ䠟෌ศᯒ⤖ᯝ䜢
䛸䜚䜎䛸䜑䛶ሗ࿌෌ศᯒᴗົ䜢ጤク኱Ꮫ䠞17

National Institute of Public Health, Japan䐟ศᯒ⤖ᯝ䛾ጇᙜᛶ䜢⛉Ꮫⓗ䛺ほⅬ䛛䜙᳨ド䛩䜛ほⅬ㻌 㻌㻌 㻌 䜰㻌 ௻ᴗཬ䜃෌ศᯒ䜾䝹䞊䝥䛾ศᯒ⤖ᯝ䛻䛴䛔䛶䚸ᶆ‽ⓗ䛺ศᯒ᪉ἲ䛸䛧䛶䛂୰ኸ♫఍ಖ㝤་⒪༠㆟఍䛻䛚䛡䜛㈝⏝ᑐຠᯝホ౯䛾ศᯒ䜺䜲䝗䝷䜲䞁䛃䛻ᇶ䛵䛔䛶ศᯒ䛥䜜䛶䛔䜛䛛㻌㻌 㻌 䜲䠄ᶆ‽ⓗ䛺ศᯒ᪉ἲ䛜ᅔ㞴䛺ሙྜ䚸䠅㑅ᢥ䛧䛯ศᯒ᪉ἲ䛻୍ᐃ䛾ྜ⌮ᛶ䛜䛒䜛䛛㻌㻌 㻌 䜴㻌 ⏝䛔䛶䛔䜛䝕䞊䝍䛜㐺ษ䛛㻌㻌 㻌 䜶㻌 ศᯒ⤖ᯝ䛾ጇᙜᛶ➼䛻㛵䛩䜛ホ౯䛜㐺ษ䛛㻌㻌䐠೔⌮ⓗ䚸♫఍ⓗᙳ㡪➼䛻㛵䛩䜛ほⅬ㻌㻌㻌㻌ቑศ㈝⏝ຠᯝẚ䠄㻵㻯㻱㻾䠅➼䛾ศᯒ⤖ᯝ䛾䜏䛷䛿ホ౯䛜ᅔ㞴䛸⪃䛘䜙䜜䜛せ⣲䚸ලయⓗ䛻䛿䚸ឤᰁ⑕ᑐ⟇䛸䛔䛳䛯බ⾗⾨⏕ୖ䛾ㄢ㢟➼䛻䛴䛔䛶᳨ウ䛩䜛䛣䛸䛸䛧䚸௒ᚋ䛾஦౛䛾⵳✚䛾୰䛷᭦䛻᳨ウ䛩䜛䛣䛸䛸䛩䜛䚹㻌㻌㻌㻌䜎䛯䚸䜲䜼䝸䝇䜔䝣䝷䞁䝇䚸䝇䜴䜵䞊䝕䞁䚸䜸䞊䝇䝖䝷䝸䜰䛸䛔䛳䛯ㅖእᅜ䛻䛚䛡䜛ከᒱ䛻䜟䛯䜛㡯┠䜢ᗈ䛟ཧ⪃䛻䛧䛴䛴䚸㆟ㄽ䜢⥆䛡䛶䛔䛟䛣䛸䛸䛩䜛䚹㻌㻌• ୍⯡ⓗ䛺་⒪ᢏ⾡ホ౯䛾ពᛮỴᐃ䛾䝥䝻䝉䝇• ㈝⏝ᑐຠᯝ䜢ྵ䜑䛯ᵝ䚻䛺せ⣲䜢⪃៖䛧䛶ホ౯䜢⾜䛖䚹
Appraisal(ホ౯)䡡 ᭷ຠᛶ䞉Ᏻ඲ᛶ➼䛾ホ౯䛾 䡡 ศᯒ⤖ᯝ䛾ゎ㔘㻌 ᐇ⾜䡡 䛭䛾௚(⮫ᗋⓗ䚸೔⌮ⓗ䚸䞉㈝⏝ᑐຠᯝホ౯䛾ᐇ⾜♫఍ⓗ…)ᙳ㡪䛾⪃៖National Institute of Public Health, Japan18⥲ྜⓗホ౯䛻䛚䛡䜛ほⅬ་⒪ᢏ⾡ホ౯䛾䝥䝻䝉䝇

Assessment(ศᯒ)

National Institute of Public Health, JapanDecision(᭱⤊Ỵᐃ)䡡 ᭱⤊ⓗ䛺ពᛮỴᐃ19

National Institute of Public Health, Japan20

ቑศ㈝⏝ຠᯝẚ䠄ICER䠅䛾ホ౯ቑศ㈝⏝ຠᯝẚ䛾ゎ㔘䛻䛴䛔䛶㉁ㄪᩚ⏕Ꮡᖺ䠄㻽㻭㻸㼅䠅䜢ຠᯝᣦᶆ䛸䛧䛯ሙྜ䛾ቑศ㈝⏝ຠᯝẚ䠄㻵㻯㻱㻾䠅䜢䜒䛸䛻䚸ከẁ㝵䛾ホ౯䛸䛩䜛䚹ุ᩿䛾┠Ᏻ䛸䛧䛶䛿䚸ᨭᡶ䛔ពᛮ㢠䜢ᇶᮏ䛸䛧䚸ᅜẸ䠍ே䛒䛯䜚䛾㻳㻰㻼➼䜒຺᱌䛩䜛䚹㻌㻵㻯㻱㻾㻌㻾ከẁ㝵ホ౯⤖ᯝ䜢ᥦ♧౛䠟౛䠟౛䠞㈝⏝ᑐຠᯝ䛜Ⰻ䛔䛸䛥䜜䜛㡿ᇦ㻌••

1QALY䛒䛯䜚䛾ቑศ㈝⏝ຠᯝẚ(ICER)䛾ゎ㔘᪉ἲ䛾୍䛴䛸䛧䛶䚸ᇶ‽䛸䛺䜛್䛸ẚ㍑䛧
䛶䚸་⒪ᢏ⾡䛾㈝⏝ᑐຠᯝ䜢ホ౯䛩䜛䛣䛸䛜䛒䜛䚹୍ᚊ䛾್䜢ᶵᲔⓗ䛻㐠⏝䛧䛶䛔䜛ᅜ䛿䛺䛔䛜䚸┠Ᏻ䛸䛺䜛್䜢ಖᣢ䛧䛶䛔䜛ᅜ䜒䛒䜛䚹䛚䜘䛭┠Ᏻ䛸䛺䜛್䛾タᐃ᪉ἲ䛸䛧䛶䛿ୗグ䛾᪉ἲ䛺䛹䛜⪃䛘䜙䜜䜛䚹(Value Health.
2004;7(5):518-28.)㻌 䐟୍⯡ⓗ䛻ᗈ䛟ཷ䛡ධ䜜䜙䜜䛶䛔䜛᪤Ꮡ䛾་⒪䛻䛛䛛䜛㈝⏝䜢┠Ᏻ䛸䛩䜛䚹౛䠝㈝⏝ᑐຠᯝ䛜ᝏ䛔㻌䛸䛥䜜䜛㡿ᇦ㻌•ホ౯⤖ᯝ䛻ᇶ䛵䛝౯᱁⟬ᐃ䠄෌⟬ᐃ䠅䜢ᐇ᪋¾ ᪤Ꮡ䛾་⒪ᢏ⾡䛾㈝⏝ᑐຠᯝ䛜䛹䛾⛬ᗘ䛷䛒䜛䛛䚹㻌 䐠 ᅜẸ䛜䛔䛟䜙䜎䛷䛺䜙ᨭᡶ䛳䛶䜒䜘䛔䛸⪃䛘䜛䛛(=ᨭᡶពᛮ㢠)¾ ౛䛘䜀᪥ᮏ䛷䛿1QALY䛒䛯䜚500~600୓෇⛬ᗘ䛸䛔䛖ㄪᰝ䛜䛒䜛䚹(኱᪥䜙(2006), Shiroiwa et al. (2010) )䠍䠊㈝⏝ᑐຠᯝ䛜䛸䛶䜒Ⰻ䛔䠎䠊㈝⏝ᑐຠᯝ䛜Ⰻ䛔䠏䠊㈝⏝ᑐຠᯝ䛿ཷ䛡ධ䜜ྍ⬟䛷䛒䜛䠐䠊㈝⏝ᑐຠᯝ䛜ᝏ䛔䠑䠊㈝⏝ᑐຠᯝ䛜䛸䛶䜒ᝏ䛔㻌 䐡 ୍ே䛒䛯䜚GDP➼䛾⤒῭ᣦᶆ¾ ౛䛘䜀WHO䛷䛿୍ே䛒䛯䜚GDP䛾1~3ಸ⛬ᗘ䛸ᥦ♧䛥䜜䛶䛔䜛䚹(WHO (2002))¾ ᪥ᮏ䛾୍ே䛒䛯䜚GDP䛾኱䛝䛥䛿420୓෇ (ෆ㛶ᗓ (2015))¾ ౛䛘䜀䚸䜲䜼䝸䝇NICE䛾20,000~30000䝫䞁䝗䛾ᇶ‽್䛿䚸䜲䜼䝸䝇䛾୍ே䛒䛯䜚GDP䛜25,000䝫䞁䝗(2013ᖺ)䛷䛒䜛䛣䛸䛛䜙䚸0.8~1.2ಸ⛬ᗘ䛷䛒䜛䚹౛䠝㻌䠖㻌୍ព䛾್䛷䛒䜛䜒䛾㻌౛䠞㻌䠖㻌䜀䜙䛴䛝䛜䛒䜛್䛷䛒䜛䛜䚸୍ᐃᖜ䛾ୖ㝈ཬ䜃ୗ㝈㢠ෆ䛻⤖ᯝ䛜཰䜎䜛䜒䛾㻌౛䠟㻌䠖㻌䜀䜙䛴䛝䛜䛒䜛್䛷䚸ୖ㝈㢠ཪ䛿ୗ㝈㢠䜢䜎䛯䛔䛷⤖ᯝ䛜♧䛥䜜䜛䜒䛾㻌䠄➨㻟㻤ᅇ㈝⏝ᑐຠᯝホ౯ᑓ㛛㒊఍㻔㻴㻞㻥㻚㻟㻚㻝㻡㻕㈨ᩱ䜘䜚䠅㻌
21

National Institute of Public Health, Japan೔⌮ⓗ䚸♫఍ⓗᙳ㡪➼䛻㛵䛩䜛ほⅬ䛛䜙⪃៖䛩䜉䛝せ⣲䛾᱌␒ྕ⪃៖䛩䜉䛝せ⣲䛾᱌22

National Institute of Public Health, Japanホ౯⤖ᯝ䛾཯ᫎ᪉ἲ¾ ㈝⏝ᑐຠᯝホ౯ᑓ㛛⤌⧊䛻䜘䜛ホ౯⤖ᯝ䛿䚸㏻ᖖ䛾⸆౯ཪ䛿≉ᐃಖ㝤་⒪ᮦᩱ
䛾౯᱁⟬ᐃ䠄෌⟬ᐃ䠅᪉ἲ䜢⏝䛔䛯ᚋ䛻䚸䛥䜙䛻౯᱁ㄪᩚ䛻⏝䛔䜛఩⨨௜䛡䛸䛩䜛䚹㻌せ⣲䛸䛧䛶⪃៖䛩䜛䛣䛸䛜ጇᙜ䛷䛒䜛䛸⪃䛘䜙䜜䜛⌮⏤¾ ౯᱁ㄪᩚ䛾ලయⓗ䛺᪉ἲ䛻䛴䛔䛶䛿䚸⸆౯⟬ᐃᑓ㛛㒊఍ཬ䜃ಖ㝤་⒪ᮦᩱᑓ㛛㒊఍䛻䛚䛔䛶䚸௒ᚋ䚸᳨ウ䛩䜛䚹㻌ICER䛻䜘䜛ศᯒ䛾≉ᛶ䜢㋃䜎䛘䛯せ⣲䠍ឤᰁ⑕ᑐ⟇䛸䛔䛳䛯බ⾗⾨⏕ ་⸆ရ䚸་⒪ᶵჾ䛜ᣢ䛴䚸ᝈ⪅ᮏே௨እ䜔≧ἣ䛾ኚ໬➼䛻ᑐ䛩䜛᭷⏝ᛶ䛻䛴䛔䛶䛿䚸ICER䛾್➼䛾ศᯒ⤖ᯝ䛾䜏䛷䛿ホ౯ᅔ㞴䛷䛒䜛䛸⪃䛘䜙䜜䜛䛯䜑䚹ⓗほⅬ䛷䛾᭷⏝ᛶ䠎බⓗ་⒪䛾❧ሙ䛛䜙䛾ศᯒ䛻 බⓗ௓ㆤ㈝⏝䞉⏕⏘ᛶᦆኻ䛻䛴䛔䛶䛿䚸ศᯒᡭἲ䛾ၥ㢟䛛䜙ᇶᮏศᯒ䛻䛿ྵ䜑䛿ྵ䜎䜜䛺䛔㏣ຍⓗ䛺㈝⏝䛺䛔䛣䛸䛸䛧䛶䛔䜛䛜䚸䛣䜜䜢ホ౯䛩䜉䛝ሙྜ䜒䛒䜛䛸⪃䛘䜙䜜䜛䛯䜑䚹䠏㛗ᮇ䛻䜟䛯䜚㔜⑕䛾≧ែ䛜⥆ 㔜⑕䛺⑌ᝈ➼䛷QOL䛜ప䛔ሙྜ䛿䚸ᘏ࿨䛻䛴䛺䛜䜛἞⒪䛾㈝⏝ᑐຠᯝ䛜㐺ษ䛻䛟⑌ᝈ䛷䛾ᘏ࿨἞⒪ホ౯䛷䛝䛺䛔ሙྜ䛜䛒䜛䛸⪃䛘䜙䜜䜛䛯䜑䚹ᾋᚸ̖ኽௐỉӒପộỂỉ්ủίಒᙲὸᾍᴾ
ᝲဇ‫ݣ‬јௐᚸ̖ᴾᝲဇ‫ݣ‬јௐᚸ̖‫ᧉݦ‬ኵጢᴾ˖ಅầᴾἙὊἑ੩Јᴾ䛭䛾௚䛾せ⣲䠐௦᭰἞⒪䛜༑ศ䛻Ꮡᅾ䛧䛺䛔 Ᏻ඲䛷᭷ຠ䛺௦᭰἞⒪䛜䛺䛔⑌ᝈ䛻ᑐ䛩䜛἞⒪䛾㛤Ⓨ䜢㜼ᐖ䛧䛺䛔䛯䜑䚹⑌ᝈ䛾἞⒪䠑䜲䝜䝧䞊䝅䝵䞁⏬ᮇᛶ䚸᪂つᛶ䛻ᐩ䜐་⸆ရ䚸་⒪ᶵჾ䛾㛤Ⓨ䜢㜼ᐖ䛧䛺䛔䛯䜑䚹䠒ᑠඣ䛾⑌ᝈ䜢ᑐ㇟䛸䛩䜛἞⒪ᡂே䛾⑌ᝈ䛸ẚ㍑䛧䛶୍⯡䛻ᕷሙつᶍ䛜ᑠ䛥䛔ᑠඣ䛾⑌ᝈ䛻ᑐ䛩䜛἞⒪䛾㛤Ⓨ䜢㜼ᐖ䛧䛺䛔䛯䜑䚹ᇹɤᎍầᴾϐЎௌửܱ଀ᴾ㻌㻌ዮӳႎᚸ̖ᴾửܱ଀ᴾᝲဇ‫ݣ‬јௐᚸ̖ᴾ‫ᧉݦ‬ኵጢỆợỦᴾᚸ̖ኽௐᴾᕤ̖ም‫ܭ‬ኵጢӍỊ̬ᨖҔၲ஬૰ሁ‫ᧉݦ‬ኵጢᴾࠊ‫ܱئ‬Ѭ̖఍ɟ‫ࡸ૾ࠢܭ‬ửᢘဇᴾ㻌㻌ɟᢿỉԼႸỆếẟềẆࠊ‫ئ‬ਘ‫ٻ‬ϐም‫ܭ‬ᴾሁỆợụ̖఍ም‫ܭ‬కử˺঺ᴾ23̖఍క̖఍ም‫ܭ‬కᴾɶɶҔңዮ˟Ệấẟềʕ১ᴾ䠄➨㻟㻤ᅇ㈝⏝ᑐຠᯝホ౯ᑓ㛛㒊఍㻔㻴㻞㻥㻚㻟㻚㻝㻡㻕㈨ᩱ䜘䜚䠅㻌䠄➨㻟㻥ᅇ㈝⏝ᑐຠᯝホ౯ᑓ㛛㒊఍㻔㻴㻞㻥㻚㻡㻚㻟㻝㻕㈨ᩱ䜘䜚䠅㻌
National Institute of Public Health, Japan‫ݣ‬ᝋԼႸỆếẟềᴾᚸ̖ኽௐỆؕỀẨᴾ̖఍ᛦૢᴾ

National Institute of Public Health, Japan24

୰་༠㻌 ᖹᡂ28ᖺᗘデ⒪ሗ㓘ᨵᐃ䛻ಀ䜛⟅⏦᭩㝃ᖏពぢ2016.2.10
䠕䠊་⸆ရ䞉་⒪ᶵჾ䛾ホ౯䛾ᅾ䜚᪉䛻㈝⏝ᑐຠᯝ⸆౯ไᗘ䛾ᢤᮏᨵ㠉䛻ྥ䛡䛯ᇶᮏ᪉㔪ᖹᡂ28ᖺ12᭶20᪥⤒῭㈈ᨻᨻ⟇ᢸᙜ኱⮧䚸ཌ⏕ປാ኱⮧ཬ䜃ᐁᡣ㛗ᐁỴᐃ䠄䠏䠅㻌 㠉᪂ⓗ᪂⸆๰ฟ䜢ಁ㐍䛩䜛䛯䜑䚸᪂⸆๰ฟ䞉㐺ᛂእ⸆ゎᾘ➼ಁ㐍ຍ⟬ไᗘ䜢䝊䝻䝧䞊䝇䛷ᢤᮏⓗ䛻ぢ┤䛩䛣䛸䛸䛧䚸䛣䜜䛸䛒䜟䛫䛶䚸㈝⏝ᑐຠᯝ䛾㧗䛔⸆䛻䛿⸆౯䜢ᘬ䛝ୖ䛢䜛䛣䛸䜢ྵ䜑㈝⏝ᑐຠᯝホ౯䜢ᮏ᱁ⓗ䛻ᑟධ䛩䜛䛣䛸➼䛻䜘䜚䚸┿䛻᭷ຠ䛺་⸆ရ䜢㐺ษ䛻ぢᴟ䜑䛶䜲䝜䝧䞊䝅䝵䞁䜢ホ౯䛧䚸◊✲㛤Ⓨᢞ㈨䛾ಁ㐍䜢ᅗ䜛䚹㻌㻌 㻌 㻌 䛺䛚䚸㈝⏝ᑐຠᯝホ౯䜢ᮏ᱁ⓗ䛻ᑟධ䛩䜛䛯䜑䚸ᑓ㛛ⓗ▱ぢ䜢㋃䜎䛘䜛䛸䛸䜒䛻䚸➨୕⪅ⓗどⅬ䛻❧䛳䛯⤌⧊䞉యไ䜢䛿䛨䜑䛸䛩䜛䛭䛾ᐇ᪋䛾䛒䜚᪉䜢᳨ウ䛧䚸᮶ᖺ୰䛻⤖ㄽ䜢ᚓ䜛䚹㻌䛾ほⅬ䜢ヨ⾜ⓗ䛻ᑟධ䛩䜛䛣䛸䜢㋃䜎䛘䛶䚸ᮏ᱁ⓗ䛺ᑟධ䛻䛴䛔䛶ᘬ䛝⥆䛝᳨ウ䛩䜛䛣䛸䚹㻌 㻌 䛒䜟䛫䛶䚸ⴭ䛧䛟㧗㢠䛺་⒪ᶵჾ䜢⏝䛔䜛་⒪ᢏ⾡䛾ホ౯䛻㝿䛧䛶㈝⏝ᑐຠᯝ䛾ほⅬ䜢ᑟධ䛩䜛ሙྜ䛾⪃䛘᪉䛻䛴䛔䛶᳨ウ䛩䜛䛣䛸䚹䠄➨㻝㻞㻟ᅇ୰་༠⸆౯ᑓ㛛㒊఍㻔㻴㻞㻤㻚㻝㻞㻚㻞㻝㻕㈨ᩱ䜘䜚䠅㻌
National Institute of Public Health, Japan25㈝⏝ᑐຠᯝホ౯䛻ಀ䜛௒ᚋ䛾㐍䜑᪉䛻䛴䛔䛶䕿㻌 ㈝⏝ᑐຠᯝホ౯䛾ヨ⾜ⓗᑟධ䛻䛛䛛䜛䛣䜜䜎䛷䛾ྲྀ⤌䛸䛂⸆౯ไᗘ䛾ᢤᮏᨵ㠉䛻ྥ䛡䛯ᇶᮏ᪉㔪䛃䜢㋃䜎䛘䚸ᖹᡂ30ᖺᗘデ⒪ሗ㓘ᨵᐃ᫬䛻䚸㈝⏝ᑐຠᯝホ౯䛾ά⏝䜢ไᗘ໬䛩䜛䜘䛖᳨ウ䜢㐍䜑䜛䛣䛸䛸䛧䛶䛿䛹䛖䛛䚹䚽㻌 ලయⓗ䛻䛿䚸་⸆ရ䚸་⒪ᶵჾ䠄㧗㢠䛺་⒪ᶵჾ䜢⏝䛔䜛་⒪ᢏ⾡䜢ྵ䜐䠅䛻䛴䛔䛶䚸ᖹᡂ30ᖺᗘデ⒪ሗ㓘ᨵᐃ᫬䛻䚸ヨ⾜ⓗᑟධ䛾᳨ウ⤖ᯝ䜢㋃䜎䛘䚸᪤཰㍕ရ䛻ຍ䛘䛶᪂つ䛻཰㍕䛩䜛་⸆ရ䚸་⒪ᶵჾ䜒ྵ䜑䛶䚸㈝⏝ᑐຠᯝホ౯䜢ά⏝䛧䛯ไᗘ໬䛾᳨ウ䜢㐍䜑䜛䛣䛸䛸䛧䛶䛿䛹䛖䛛䚹䕿㻌 ᳨ウ䛻ᙜ䛯䛳䛶䛿䚸⸆౯ᑓ㛛㒊఍䚸ಖ㝤་⒪ᮦᩱᑓ㛛㒊఍䛻䛚䛡䜛㈝⏝ᑐຠᯝホ౯䛾౯᱁䜈䛾཯ᫎ᪉ἲ䛻㛵䛩䜛᳨ウ䛻ྥ䛡䛶䚸ᮏᖺኟ䜢┠㏵䛻୍ᐃ䛾⤖ㄽ䜢ᚓ䜛䛣䛸䛸䛧䛶䛿䛹䛖䛛䚹ᮏ᱁ⓗ䛺ᑟධ䛻ྥ䛡䛶᳨ウ䛩䜉䛝஦㡯ᑗ᮶ⓗ䛺ᮏ᱁ⓗ䛺ᑟධ䛻ྥ䛡䛶䛿䚸యไ➼䛾ᩚഛ䛻ຍ䛘䚸௨ୗ䛾䜘䛖䛺஦㡯䛻䛴䛔䛶㆟ㄽ䜢ᘬ䛝⥆䛝⾜䛖䛣䛸䛸䛩䜛䚹㻌 䐟 㑅ᐃᇶ‽䛾ぢ┤䛧㻌 䐠 ೔⌮ⓗ䚸♫఍ⓗᙳ㡪➼䛻㛵䛩䜛ほⅬ䛛䜙⥲ྜⓗホ౯䠄䜰䝥䝺䜲䝄䝹䠅䜢⾜䛖㝿䛾䚸ᮏ㑥䛻䛚䛡䜛ලయⓗ䛺せ⣲㻌 䐡 ㎿㏿䛺ホ౯䛻ᚲせ䛺యไ䜔䚸᪂つ཰㍕᫬䛻ᥦฟ䛜⾜䜟䜜䜛䝕䞊䝍䛾㉁䜔ෆᐜ➼㻌 䐢 ᪥ᮏ䛻䛚䛡䜛䝕䞊䝍ᩚഛ䛻ಀ䜛ྲྀ⤌䛾᥎㐍㻌 䐣 ホ౯⤖ᯝ䛻ᇶ䛵䛝ൾ㑏䛾ྍྰ䛾ุ᩿䜢⾜䛖ሙྜ䛾ලయⓗ䛺ྲྀᢅ䠄➨㻟㻣ᅇ㈝⏝ᑐຠᯝホ౯ᑓ㛛㒊఍㻔㻴㻞㻥㻚㻞㻚㻤㻕㈨ᩱ䜘䜚䠅㻌
National Institute of Public Health, Japan

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National Institute of Public Health, Japan䠄➨㻟㻞ᅇ㈝⏝ᑐຠᯝホ౯ᑓ㛛㒊఍㻔㻴㻞㻣㻚㻝㻞㻚㻝㻢㻕㈨ᩱ䜘䜚䠅㻌
National Institute of Public Health, Japan

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QOL䝕䞊䝍䝧䞊䝇᪂₲་⒪⚟♴኱Ꮫ㻌 ་⒪⤒῭䞉QOL◊✲䝉䞁䝍䞊29

National Institute of Public Health, Japan䜎䛸䜑䕿ᖹᡂ䠎䠔ᖺᗘ䜘䜚୰ኸ♫఍ಖ㝤་⒪༠㆟఍䠄୰་༠䠅䛻䛚䛔䛶䚸་⸆ရ䞉་⒪ᶵჾ䛾㈝⏝ᑐຠᯝホ౯䛾ヨ⾜ⓗᑟධ䛜ᐇ᪋䛥䜜䛶䛚䜚䚸ホ౯⤖ᯝ䛿ᖹᡂ䠏䠌ᖺᗘ䛾デ⒪ሗ㓘ᨵᐃ᫬䛻ൾ㑏౯᱁䛾ㄪᩚ䛻⏝䛔䜙䜜䜛ணᐃ䛷䛒䜛䚹㻌䕿ศᯒ䜺䜲䝗䝷䜲䞁䛷䛿䚸ຠᯝᣦᶆ䛸䛧䛶㉁ㄪᩚ⏕Ꮡᖺ䠄㻽㻭㻸㼅䠅䜢⏝䛔䜛䛣䛸䜢ᇶᮏ䛸䛧䛶䛔䜛䚹㻌䕿㻽㻻㻸್䛿ᾏእ䛾䜒䛾䜢⏝䛔䜛䛣䛸䜒ྍ⬟䛰䛜䚸ᅜෆ䛷䛾ㄪᰝ⤖ᯝ䜢⏝䛔䜛䛣䛸䛜ᮃ䜎䛧䛔䚹㻌䕿ᖹᡂ䠏䠌ᖺᗘ䛛䜙䛾㈝⏝ᑐຠᯝホ౯䛾ไᗘ໬䛻ྥ䛡䛯㆟ㄽ䛜㐍䜣䛷䛔䜛䚹㻌䕿௒ᚋ䚸ᅜෆ䛷䛾㻽㻻㻸್ㄪᰝ䛾᥎㐍䜔䛣䜜䜢⏝䛔䛯ศᯒ䛾ᐇ᪋䛜ᚲせ䛸䛺䜛䚹㻌㻌National Institute of Public Health, Japan

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National Institute of Public Health, Japan30