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診療報酬による誘導の限界① 診療報酬による誘導の限界②

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診療報酬による誘導の限界① 診療報酬による誘導の限界②
デ⒪ሗ㓘䛻䜘䜛ㄏᑟ䛾㝈⏺䐟
• ᅄ⑓㝔ᅋయ༠㆟఍ᥦฟ㈨ᩱ
– ་⒪ἲ࣭デ⒪ሗ㓘㸸୧㍯࡜ࡋ࡚ᶵ⬟ࡋ࡚࡯ࡋ
࠸
• デ⒪ሗ㓘࡟ࡼࡿ⤒῭ㄏᑟࡔࡅ࡛ࡣ↓⌮ࡀ࠶ࡿ㸸⾜
ࡁ㐣ࡂࡢ౛㸦㸵ᑐ㸯┳ㆤ㸧
• 㐺ษ࡞ホ౯㸸ࢫࢺࣛࢡࢳ࣮࣭ࣕࣉࣟࢭࢫ㸦ᶵ
⬟㸧࣭࢔࢘ࢺ࣒࢝ホ౯
• ඲ᅜ୍ᚊ࡛ࡣ࡞ࡃᆅᇦࡢᐇ᝟࡟ྜ⮴ࡋࡓᥦ౪యไ
ᩚഛࢆ㐍ࡵࡿ
9
デ⒪ሗ㓘䛻䜘䜛ㄏᑟ䛾㝈⏺䐠
• 䛂᪥ᮏⓗ་⒪ၥ㢟䛾ゎỴ䛻㐨➽䜢䛅䛄㐌หᮾὒ
⤒῭䛅2013ᖺ3᭶16᪥ྕ
– ᪥ᮏ䛾་⒪ᨻ⟇䛿䚸デ⒪ሗ㓘䛻䜘䜛฼┈ㄏᑟ䛷ᒎ
㛤䛥䜜䛶䛝䛯䛜䚸䛣䛾ᡭἲ䛿་⒪䝙䞊䝈䛻ぢྜ䛳䛯
ᥦ౪యไ䛾ᩚഛ䛻㛵䛧䛶䛿㝈⏺䛜䛒䛳䛯䚹䛒䜛デ⒪
⾜Ⅽ䛾ᬑཬ䜔䚸䛒䜛ᥦ౪యไ䛾ᩚഛ䜢䛽䜙䛳䛶㧗䜑
䛾Ⅼᩘ䜢タᐃ䛩䜛䛸䚸䛭䛾᪉ྥ䛻་⒪ᶵ㛵䛜୍ᩧ䛻
ື䛝㐣䛞䜛䛸䛔䛖≧ἣ䛜⧞䜚㏉䛧㉳䛣䛳䛶䛝䛯䚹
䜎䛯䚸ྛᅜ䛷㧗㱋໬䛜㐍䜏䚸䛭䜜䜎䛷ᩚഛ䜢㐍䜑
䛶䛝䛯ᛴᛶᮇ་⒪䛿㧗㱋⪅䛻䛿୙せ䚸୙ྥ䛝䛷䛒䜛
䛸ุ᩿䛧䛯ᅜ䚻䛿䚸70ᖺ௦ᮎ䛛䜙⑓ᗋ䜢ῶ䜙䛧䛶䛝䛯
䛾䛻䚸᪥ᮏ䛰䛡䛜ቑ䛘⥆䛡䚸௒䛿㧗Ṇ䜎䜚䛧䛯䜎䜎䛸
䛺䛳䛶䛔䜛䚹
10
26
デ⒪ሗ㓘䛻䜘䜛ㄏᑟ䛷ゎỴ䛷䛝䛺䛛䛳䛯
⑓㝔⑓ᗋ䛻㛵䛩䜛᪥ᮏ་⒪䛾≉ᚩ䐟
•
㧑ᶰၿ୍炷2005䛊ึ∧2001䛋䠅䛄෌ศ㓄ᨻ⟇䛾ᨻ἞⤒῭Ꮫ ➨䠎∧䛅219㡫
11
デ⒪ሗ㓘䛻䜘䜛ㄏᑟ䛷ゎỴ䛷䛝䛺䛛䛳䛯
MRI䞉CT➼㧗㢠ᶵჾ䛾タ⨨䛻㛵䛩䜛᪥ᮏ་⒪䛾≉ᚩ䐠
MRI units, 2009 (or nearest year)
Hospital
Japan
United States
Iceland
Greece
Italy
Korea
Austria
Finland
Denmark
Luxembourg
OECD
Ireland
Netherlands
Belgium ¹
Spain ¹
New Zealand
Germany ¹
Portugal
Turkey
Canada
Estonia
France
Slovak Republic
Australia ²
Czech Republic
United Kingdom ³
Slovenia
Poland
Hungary
Israel
Mexico
Outside hospital
Hospital
Total
Japan
Australia ²
Korea
Iceland
United States
Greece
Switzerland
Italy
Austria
Luxembourg
Portugal
Denmark
OECD
Finland
Germany ¹
Ireland
Spain ¹
Estonia
New Zealand
Czech Republic
Canada
Belgium ¹
Slovak Republic
Poland
Slovenia
Turkey
Netherlands
France
Israel
United Kingdom ³
Hungary
Mexico
43.1
25.9
21.9
21.7
21.6
19.0
18.4
16.9
15.4
14.2
12.2
11.9
11.0
10.7
10.0
9.7
9.5
8.9
8.9
8.0
7.5
6.4
6.1
5.9
5.7
5.6
4.5
3.7
2.8
1.9
1.9
0
10
20
30
40
CT scanners, 2009 (or nearest year)
50
Per million population
Outside hospital
Total
97.3
38.7
37.1
34.5
34.3
33.8
32.8
31.7
29.3
26.3
26.0
23.7
22.8
20.4
17.2
15.3
15.1
14.9
14.6
14.1
13.9
13.5
13.3
12.4
11.9
11.6
11.3
11.1
9.4
7.4
7.2
4.3
0
20
40
60
80
100
Per million population
Note: The OECD average does not include countries which only report
equipment in hospital (Belgium, Germany and Spain).
1. Equipment outside hospital not included.
2. Only equipment eligible for reimbursement under Medicare.
3. Any equipment in the private sector not included.
27
12
Source: OECD Health Data 2011
デ⒪ሗ㓘䛻䜘䜛ㄏᑟ䛷ゎỴ䛷䛝䛺䛛䛳䛯
⑓㝔⑓ᗋ䛻㛵䛩䜛᪥ᮏ་⒪䛾≉ᚩ䐡
➨6ᅇ♫఍ಖ㞀ไᗘᨵ㠉ᅜẸ఍㆟㓄௜㈨ᩱ ♫఍ಖ㞀䛻ಀ䜛㈝⏝䛾ᑗ᮶᥎ィ䛻䛴䛔䛶 19㡫
13
⌧⾜ィ⏬䛾๓ಽ䛧䛾せㄳ
• ᅄ⑓㝔ᅋయ༠㆟఍௦⾲ሜ᪥ᮏ⑓㝔఍఍㛗
䠄➨7ᅇ♫఍ಖ㞀ไᗘᨵ㠉ᅜẸ఍㆟ 3᭶27᪥䠅
– ᪤䛻䠐᭶䛻ጞ䜎䜛ḟᖺᗘ䛻䛿᪂䛯䛺་⒪ィ⏬䛜
⟇ᐃ䛥䜜䛶䛚䜚䜎䛩䚹䛯䛰䚸䛭䛾ḟ䛸䛔䛖䛾䛿䠑ᖺ
ඛ䛷䛩䛛䜙䚸䛭䜣䛺䛻ᚅ䛴䛣䛸䛿䛷䛝䛺䛔䛸ᛮ䛳
䛶䛚䜚䜎䛩䚹䛬䜂๓ಽ䛧䜢䛧䛯⟇ᐃ䜢䜔䛳䛶䛔䛯
䛰䛡䛺䛔䛛䛸ᛮ䛳䛶䛚䜚䜎䛩䚹
14
28
⌧⾜ィ⏬
➨䠍ᅇ⑓ᗋᶵ⬟᝟ሗ䛾ሗ࿌䞉ᥦ౪䛾ලయⓗ䛺䛒䜚᪉䛻㛵䛩䜛᳨ウ఍㈨ᩱ
15
ᆅᇦ་⒪䞉ໟᣓ䜿䜰๰⏕ᇶ㔠
ᆅᇦ་⒪ィ⏬䛸ᆅᇦໟᣓ
䜿䜰ィ⏬䜢㋃䜎䛘䛶䚸㈨㔠
䛾㔜Ⅼ㓄ศ
䠄㈈※䛿ᾘ㈝⛯䠅
䝅䞁䜽䝍䞁䜽ᶵ⬟
๓ಽ䛧
ᆅᇦ䛾་⒪௓ㆤ㈨※䛾᝟ሗ཰㞟䛸
䝡䝆䝵䞁స䜚ᖹ⾜
་⒪䞉௓ㆤᥦ౪యไᨵ㠉᥎㐍ᮏ㒊
䞉ᆅᇦ་⒪䞉ໟᣓ䜿䜰䝕䞊䝍ゎᯒᑓ㛛䝏䞊䝮
㟂せ䝢䞊䜽᫬䜎䛷䛾ྍど໬
ሗ࿌ෆᐜ䛾ጇᙜᛶ䝏䜵䝑䜽
᝟ሗᥦ౪䞉䜰䝗䝞䜲䝇
29
ᆅᇦ་⒪䞉ໟᣓ䜿䜰䝡䝆䝵䞁
䠄㟂せ䝢䞊䜽᫬䜎䛷䛾䝡䝆䝵䞁䠅
ィ⏬స䜚
ᆅᇦ་⒪ィ⏬
ᆅᇦໟᣓ䜿䜰ィ⏬
16
་⒪௓ㆤ㟂せ䝢䞊䜽᫬䜎䛷䛾
ᆅᇦ་⒪䞉ໟᣓ䜿䜰䝡䝆䝵䞁సᡂ䛸ᖹ⾜䛧䛺䛜䜙
• ྛ㒔㐨ᗓ┴䛜䠎ḟ་⒪ᅪ䛤䛸䛻ᇶ‽⑓ᗋᩘ䜢㧗ᗘᛴᛶᮇ䞉୍⯡
ᛴᛶᮇ䞉ளᛴᛶᮇ䛸䛔䛳䛯᪂䛯䛺་⒪ᶵ⬟ู䛻⟬ᐃ䛧䠄ᅜ䛜ᶆ‽
䜢♧䛧䛴䛴䚸ᆅᇦ䛾ᐇ᝟䛻ᛂ䛨䛶㒔㐨ᗓ┴䛜⿵ṇ䜢⾜䛖䠅䚸ᆅᇦ་
⒪ィ⏬䛻┒䜚㎸䜐䚹
• 䛭䛾ᐇຠᛶ䜢㧗䜑䜛䛯䜑䚸ᚋ㏙䠄51㡫ཧ↷䠅䛩䜛䛸䛚䜚䚸་⒪ィ⏬
䛾⟇ᐃ⪅䛷䛒䜛㒔㐨ᗓ┴䜢ᅜಖ䛾ಖ㝤⪅䛸䛩䜛䚹
• 䛥䜙䛻䛿་⒪ィ⏬䛾⟇ᐃ⪅䛷䛒䜛㒔㐨ᗓ┴䛻ಖ㝤་⒪ᶵ㛵䛾ᣦ
ᐃ䞉ྲྀᾘᶒ㝈䜢୚䛘䜛䜋䛛䚸ᐇຠᛶ䜢㧗䜑䜛䛯䜑䛾ㅖ᪋⟇䜢ㅮ䛪
䜛
• ་⒪ᶵ⬟䛾ศ໬䞉㐃ᦠ䛾䛯䜑䛾་⒪ᶵ㛵䛾෌⦅➼䜢ྍ⬟䛸䛧䚸䜿
䜰䜢䝧䞊䝇䛸䛧䛯䝁䝭䝳䝙䝔䜱ᙧᡂ䚸⏫䛵䛟䜚䛻䜒ཧ⏬䛷䛝䜛䜘䛖䛻
་⒪ἲேไᗘ䛾ぢ┤䛧䜢⾜䛖䚹
䛺䛹䛾᪉⟇䜢᳨ウ䛩䜛䚹
• ᆅᇦ་⒪䝡䝆䝵䞁䛾๓ಽ䛧䛷䛾⟇ᐃ䛻ຍ䛘䚸ୖグ䛾᪉ྥᛶ䜢་⒪
ἲᨵṇ䛷᫂♧䛩䜛䚹
17
ᆅᇦໟᣓ䜿䜰ィ⏬䛾⟇ᐃ
• ᕷ⏫ᮧ䛜୺య䛸䛺䛳䛶䚸ᆅᇦ䛾㧗㱋໬䝢䞊䜽᫬
䜎䛷䛾ィ⏬䜢⟇ᐃ䚹
• ௓ㆤ䛰䛡䛷䛺䛟䚸ᅾᏯ་⒪䚸ఫ䜎䛔䚸⏕άᨭ᥼䚸
ண㜵䜢఩⨨䛵䛡䜛䚹
• ┴䛸ᕷ⏫ᮧ䛸䛜୍య䛸䛺䛳䛶ィ⏬䛵䛟䜚䛜ᚲせ䚹
• ≉䛻䛂ఫ䜎䛔䛃䛾☜ಖ䛿䚸⑓㝔䛛䜙䛾㛗ᮇ⒪㣴
ᝈ⪅䜔௓ㆤ᪋タ䛛䜙䛾㍍ᗘせ௓ㆤ⪅䛾ཷ─䛸
䛧䛶䜒㔜せ䠄29㡫ཧ↷䠅䚹
• ་⒪ἲே䜒䛣䛖䛧䛯⏫䛵䛟䜚䛻✚ᴟⓗ䛻ཧຍ䚹
18
30
⑓㝔ᶵ⬟ศ໬䛾
䠎ḟ་⒪ᅪ䝅䝭䝳䝺䞊䝅䝵䞁
• 䠎䛴䛾䠎ḟ་⒪ᅪ䛾ᨵ㠉ヨ⟬
19
䠎䛴䛾䠎ḟ་⒪ᅪ䛾
ேཱྀ䛾⌧≧(2010)䛸2025ᖺ䛾ぢ㏻䛧
20
31
䠎䛴䛾䠎ḟ་⒪ᅪ䛾་⒪ᥦ౪యไ
་⒪ᥦ౪యไ䛾ᨵ㠉䛜
㐨➽㏻䜚䛻㐍䜣䛰ሙྜ䠄2ḟ་⒪ᅪ䠝䠅
22
32
་⒪ᥦ౪యไ䛾ᨵ㠉䛜
㐨➽㏻䜚䛻㐍䜣䛰ሙྜ䠄2ḟ་⒪ᅪ䠞䠅
23
⯙㭯ᕷ䛾஦౛
ᑡ䛺䛔་ᖌ䛜ศᩓ䛧䛶ᝈ⪅䜢ዣ䛔ྜ䛖≧ἣ
• ⯙㭯ᕷෆ
– ᅜᐙබົဨඹ῭㐃ྜ⤌ྜ䚸⊂❧⾜ᨻἲே䞉ᅜ❧⑓
㝔ᶵᵓ䚸⯙㭯㉥༑Ꮠ⑓㝔䚸⚾❧⯙㭯ᕷẸ⑓㝔
• ᕷ㛗䛾⚾ⓗㅎၥᶵ㛵䛂⯙㭯ᆅᇦ་⒪䛒䜚᪉᳨ウ
ጤဨ఍䛃2007ᖺᙜ᫬
– ་ᖌ୙㊊䚸ປാ⎔ቃᝏ໬䛾ᝏᚠ⎔
• ⤫ྜ᱌䜢ᥦ᱌
– ་ᖌ䜢㞟୰䛥䛫䛶໅ົ་䛾㈇ᢸ䜢ῶ䜙䛧䚸་ᖌῶᑡ
䛻ṑṆ䜑䜢䛛䛡䜛䚹୍ᐃ䛾ᡭ⾡௳ᩘ䛜䛒䜛⑓㝔䛷ᢏ
⾡䜢☻䛝䛯䛔་ᖌ䜢࿧䜃㎸䜏䜔䛩䛔⎔ቃ䜒┠ᣦ䛩
• ቨ䜢஌䜚ษ䜛䛣䛸䛿䛷䛝䛪
33
24
ゎỴ䛾᪉ྥᛶ䛿
• 㐣ᙜ➇த䛛䜙⑓㝔⤒Ⴀ䜢ᩆ䛖㐨䛿
• 㠀Ⴀ฼䜢ཝṇ໬䛧䛶ᆅᇦ⊂༨䜢チᐜ
– 㧗ᗘᛴᛶᮇ་⒪䛿䚸኱Ꮫ⑓㝔䚸ᅜ❧⑓㝔䚸බⓗ⑓㝔
䠄᪥㉥䞉῭⏕఍䞉ඹ῭䞉ཌ⏕㐃➼䠅ཬ䜃⮬἞య⑓㝔䛜
ᢸ䛳䛶䛔䜛ሙྜ䛜ከ䛔䚹䛣䜜䜙䛾㐠Ⴀ୺య䛜䛭䜜䛮
䜜䛻⊂❧䛧䛯䜎䜎䛷ᶵ⬟ศᢸ䛧䜘䛖䛸䛧䛶䜒䚸⤒Ⴀୖ
䛾฼ᐖ䛜䜆䛴䛛䜛䛯䜑䛖䜎䛟䛔䛛䛺䛔䚹
– 䛣䛾䛯䜑䚸ᆅᇦ䛾୰䛷䚸」ᩘ䛾⑓㝔䛜䜾䝹䞊䝥໬
䛧䚸⑓ᗋ䜔デ⒪⛉䛾タᐃ䚸་⒪ᶵჾ䛾タ⨨䚸ே஦䚸
་⒪஦ົ䚸௙ධ䜜➼䜢⤫ྜ䛧䛶⾜䛖䛣䛸䛜䛷䛝䜛⎔ቃ
䜢స䜛䚹
25
• ᪂ᆺ་⒪ἲே䠄䛯䛸䛘䜀䚸㠀Ⴀ฼䝩䞊䝹䝕䜱
䞁䜾䜹䞁䝟䝙䞊䠅䛾ᯟ⤌䜏䜢๰タ䛧䚸ᆅඖ䛾
せㄳ䛻ᇶ䛵䛝䛭䛣䛻ཧ⏬䛩䜛ሙྜ䛻䛿䚸ᅜ❧
⑓㝔䜔බⓗ⑓㝔䛿ᮏ㒊䛛䜙ษ䜚㞳䛥䜜䜛䛣䛸
䜢ἲᚊⓗ䛻ᢸಖ䛩䜛䚹
• 䛣䛾䜘䛖䛺᪂ᆺ་⒪ἲே䛿䚸ᆅᇦ䛾୰䛾୰ᑠ
Ẹ㛫⑓㝔䜔デ⒪ᡤ䚸௓ㆤ஦ᴗᡤ➼䛸䛾ඹᏑ
䜢๓ᥦ䛸䛧䚸ᆅᇦ㐃ᦠ䝟䝇䜔⤂௓䞉㏫⤂௓䛾
᥎㐍䛻ດ䜑䜛䛣䛸䛸䛩䜛䚹
26
34
ᆅᇦ་⒪䞉ໟᣓ䜿䜰䝕䞊䝍ゎᯒᑓ㛛䝏䞊䝮䐟
• ୍యᨵ㠉䜢䝣䜷䝻䞊䜰䝑䝥䛩䜛䛂་⒪䞉௓ㆤᥦ౪
యไᨵ㠉᥎㐍ᮏ㒊䛃䜢タ⨨䛧䚸䛭䛾ୗ䛻䚸䛂ᆅᇦ
་⒪䞉ໟᣓ䜿䜰䝕䞊䝍ゎᯒᑓ㛛䝏䞊䝮䛃䜢⨨䛟䚹
• ་⒪䚸௓ㆤ䚸┳ྲྀ䜚䜎䛷⥅䛞┠䛾䛺䛔ᆅᇦ་⒪䞉
ໟᣓ䜿䜰䜢๰⏕䛩䜛䛯䜑䛻䛿䚸ேཱྀ᥎ィ䜢䛿䛨
䜑䚸ᆅᇦ䛾≉ᛶ䛻㓄៖䛧䛯་⒪௓ㆤ㈨※䛸䝙䞊
䝈䛻㛵㐃䛩䜛䝕䞊䝍䛾ྍど໬䛜㔜せ䚹
• ྛᆅᇦ䛛䜙䛾ሗ࿌ෆᐜ䛾ጇᙜᛶ䜢䝏䜵䝑䜽䚹
• ᪤Ꮡ䝕䞊䝍䜢㞟⣙䞉⤫ྜ䛧䚸㊊䜙䛦䜛䝕䞊䝍䛿཰
㞟䛩䜛䛣䛸䛻䜘䜚䚸ఫẸ䚸ᆅᇦ་⒪ィ⏬䚸ᆅᇦໟ
ᣓ䜿䜰ィ⏬సᡂ⪅䛻ᥦ౪䛧䛶䛔䛟䚹
27
ᆅᇦ་⒪䞉ໟᣓ䜿䜰䝕䞊䝍ゎᯒᑓ㛛䝏䞊䝮䐠
• ᭷㆑⪅䜔ᅜ䛾⫋ဨ➼䛛䜙ᡂ䜛䛂ᆅᇦ་⒪䞉ໟ
ᣓ䜿䜰䝕䞊䝍ゎᯒᑓ㛛䝏䞊䝮䛃䛿䚸ᆅᇦ་⒪
ィ⏬⟇ᐃ⪅䜔ᆅᇦໟᣓ䜿䜰ィ⏬⟇ᐃ⪅䛸⥭
ᐦ䛻㐃ᦠ䛧䛺䛜䜙䚸ྍど໬䛥䜜䛯᝟ሗ䛻䛴䛔
䛶䛾ㄝ᫂䜔ゎㄝ䜢⾜䛔䚸㒔㐨ᗓ┴༢఩䜔་
⒪ᅪ༢఩䚸ᆅᇦໟᣓ䜿䜰༢఩䛷䛾䛂䛒䜛䜉䛝
ጼ䛃䛾᳨ウ䜢䛩䛩䜑䛶䛔䛟䚹
28
35
་⒪䛾ᶵ⬟ศ໬䚸㏥㝔䛾ཷ䛡─ၥ㢟
䠄2ḟ་⒪ᅪA,Bᨵ㠉䝅䝭䝳䝺䞊䝅䝵䞁䠅
• ་⒪䛾ᶵ⬟ศ໬䛾䛯䜑䛻䛿䚸䛧䛳䛛䜚䛧䛯ᆅᇦໟᣓ䜿䜰䜢ᵓ⠏䛧
䛺䛡䜜䜀䛺䜙䛺䛔䚹䜎䛯䚸௓ㆤ᪋タ฼⏝䛾㐺ṇ໬䛾䛯䜑䛻䜒⏫䛾
䜲䞁䝣䝷స䜚䛾඲యⓗ䛺ྲྀ䜚⤌䜏䛜ᚲせ䚹
– ௓ㆤ䛿䚸24᫬㛫ᕠᅇᆺ௓ㆤ䚸ゼၥ┳ㆤ䛺䛹䛷䚸㔜ᗘせ௓ㆤ⪅䛾ᅾᏯ
⏕ά㝈⏺Ⅼ䜢㧗䜑䜛䚹
– 䝃䞊䝡䝇௜䛝㧗㱋⪅ఫᏯ䠄ఫ䜎䛔䠇⏕άᨭ᥼➼䠅䛾ᩚഛ䚹
– ᩘⓒ୓ᡞ䛸䜒ゝ䜟䜜䛶䛔䜛✵䛝ᐙ䞉✵䛝᪋タ䛺䛹᪤Ꮡ♫఍㈨※䛾᭷
ຠά⏝䚹
• 䛣䛾䛯䜑䛾ᨵಟ䜔䝬䝑䝏䞁䜾䛾᥎㐍䜢㜼䜐つไ⦆࿴䛜ᚲせ䚹
29
┳ㆤ䝬䞁䝟䝽䞊ၥ㢟
䠄2ḟ་⒪ᅪA,Bᨵ㠉䝅䝭䝳䝺䞊䝅䝵䞁䠅
‫ٹ‬঳৬੝୓पेॊ่૧૙৩भ૑ਏਯ ৺‫ڱڭ‬ফद ٔ‫ڬڱ‬ਐয
‫ٹ‬૘৕৲ऋਤिর‫௷ؚ‬ম৓ऩ่૧૙৩ન৳ৌੁऋਂ૭ಳ
2011(H23)ᖺ
┳ㆤ⫋ဨ
⣙䠍䠑䠌୓ே
‫ڋ‬ᅯ˾‫ݒ‬঄҅̔ң҉෱ࡻр‫ޗݠ‬
2025(H37)ᖺ
┳ㆤ⫋ဨ
⣙䠎䠌䠌୓ே
30
36
┳ㆤ⫋ဨ☜ಖ⟇
• ₯ᅾ┳ㆤ⫋ဨ⣙55୓ே
– ་ᖌ䚸⸆๣ᖌ䛸ྠ䛨䜘䛖䛻䚸චチ䜢䛂Ⓩ㘓ไ䛃䛻䛧䚸₯
ᅾ┳ㆤᖌ䜢ᢕᥱ䛷䛝䜛බⓗ䝅䝇䝔䝮䜢☜❧䛩䜛䚹䛣
䛾䝅䝇䝔䝮䜢⏝䛔䛶䚸◊ಟ䝥䝻䜾䝷䝮䚸┦ㄯᨭ᥼䛺䛹
䛾᚟⫋ᨭ᥼䝥䝻䜾䝷䝮䛸୍యⓗ䛻ᥦ౪䚹
• 㣴ᡂ䛾ᣑ኱
– ኱༞㈨᱁⪅䛻䚸䠎ᖺ㛫䛾▷ᮇ㞟୰䝥䝻䜾䝷䝮䜢๰タ
䠄୺䛻㛗ᮇఇᬤ䜢▷⦰䠅䚹
• 㞳⫋㜵Ṇ䞉ᐃ╔ಁ㐍
– 䛝䛴䛔་⒪⌧ሙ䛾໅ົ⎔ቃᨵၿ
31
ᨵ㠉䛾䝍䜲䝭䞁䜾䚸䝇䝢䞊䝗䛸
᪤Ꮡ㈈ᨻィ⏬䛸䛾ㄪᩚ
• ୍యᨵ㠉䛷䛿䚸ᨵ㠉䛜䛒䛯䛛䜒䛩䜏䜔䛛䛻ᐇ⾜䛥
䜜䚸䛭䛾ຠᯝ䜒䛩䛠䛻⌧䜜䜛䛣䛸䜢๓ᥦ䛸䛧䛯㈈ᨻィ
⏬䛜❧䛶䜙䜜䛶䛔䛯䛜䚸௨ୖ䛾་⒪ᥦ౪యไᨵ㠉䛾
㐨➽䜢㋃䜎䛘䚸෌⪃䛾ᚲせ䛜ฟ䛶䛟䜛䛿䛪䛷䛒䜛䚹
– 䛯䛸䛘䜀䚸་⒪ᥦ౪యไᨵ㠉䛻䜘䜚2015ᖺᗘ䜎䛷䛻ᖹᆒ
ᅾ㝔᪥ᩘ䛾ῶᑡ➼䛷4,400൨෇䛾ຠ⋡໬䛜⏕䛨䜛䛣䛸䜢
ぢ㎸䜣䛷䚸䛭䜜䜒㈈※䛸䛧䛯බ㈝䛾㏣ຍ䛜ィ⏬䛥䜜䛶䛔
䛯䛜䚸䛥䛩䛜䛻2015ᖺᗘ䜎䛷䛻䛭䛾ຠᯝ䜢ᮇᚅ䛩䜛䛣䛸
䛿㞴䛧䛔䛾䛷䛿䛺䛔䛛䚹
– 䜎䛯䚸እ᮶ཷデ䛾㐺ṇ໬䛻䜘䜛1,300൨෇䛾㈈※☜ಖ䜒
2015ᖺᗘ䜎䛷䛻ຠᯝ䜢ぢ㎸䜐䛣䛸䛜䛷䛝䜛䛾䛛䚹
• 䛔䛪䜜䛿ᐇ⌧䛩䜛┠ᶆ䛷䛒䜛䛸䛧䛶䜒䚸ᨵ㠉䛾䝍䜲䝭
䞁䜾䚸䝇䝢䞊䝗䛸䛣䜜䜎䛷䛾㈈ᨻィ⏬䛸䛾ㄪᩚ䛿⾜䜟
䛺䛟䛶䛿䛺䜙䛺䛔䚹
32
37
་⒪௓ㆤᥦ౪యไᨵ㠉䛾୰䛷䛾
⤊ᮎᮇ་⒪䛾ᅾ䜚᪉
• 䛄♫఍ಖ㞀ไᗘᨵ㠉᥎㐍ἲ䛅
– ಶே䛾ᑛཝ䛜㔜䜣䛬䜙䜜䚸ᝈ⪅䛾ពᛮ䛜䜘䜚ᑛ㔜䛥䜜䜛䜘䛖
ᚲせ䛺ぢ┤䛧䜢⾜䛔䚸≉䛻ே⏕䛾᭱⤊ẁ㝵䜢✜䜔䛛䛻㐣䛤䛩
䛣䛸䛜䛷䛝䜛⎔ቃ䜢ᩚഛ
• ௒ᚋ䛾䛥䜙䛺䜛㧗㱋⪅ேཱྀ䛾ቑຍ䛾୰䛷䚸ᆅᇦໟᣓ䜿䜰
ᆺ་⒪䞉௓ㆤ䜢㐍䜑䜛䛸䚸ᅾᏯ䛷䛾┳ྲྀ䜚ᩘ䛜ቑຍ䛩䜛䚹
Ṛஸ๓䠍䞄᭶⛬ᗘ䛾⤊ᮎᮇ་⒪䛿ᚲ䛪䛧䜒㧗㢠䛷䛿䛺䛟
་⒪㈝䛾ᙉ䛔ቑຍᅽຊ䛻䛺䛳䛶䛔䜛䜟䛡䛷䛿䛺䛔䜒䛾
䛾䚸䛄♫఍ಖ㞀ไᗘᨵ㠉᥎㐍ἲ䛅䛻䛚䛡䜛ୖグ䛾つᐃ䛻
ἢ䛖䛯䜑䛻䜒䚸⤊ᮎᮇ་⒪䛾䛒䜚᪉ 䛻䛴䛔䛶ᅜẸⓗྜព
䜢ᙧᡂ䛩䜛ᚲせ䛜䛷䛶䛟䜛䚹
• 䛯䛸䛘䜀䚸䝸䝡䞁䜾䜴䜱䝹䛻䜘䜛ᘏ࿨ᥐ⨨䛾୙㛤ጞཪ䛿୰
Ṇ䛻䛴䛔䛶䚸Ẹ஦䚸ฮ஦䚸⾜ᨻୖ䛾ྲྀ䜚ᢅ䛔䛻㛵䛧䛶
➼䚻䚹
33
་⒪⏺䛛䜙䛾ྍど໬䛾せㄳ
• ᅄ⑓㝔ᅋయ༠㆟఍ᥦฟ㈨ᩱ
– ࠕぢ࠼ࡿ໬ࠖࡢ᥎㐍㸸ᚲせ࡞ࢹ࣮ࢱࡢᩚഛ࣭
㛤♧ࢆᮃࡴ
• ᆅᇦࡢ་⒪㟂せ࣭౪⤥ࢆ♧ࡍ࣑ࢡࣟࢹ࣮ࢱࡀ୙ྍ
Ḟ
• デ⒪ሗ㓘࣭᪋タᇶ‽ࢹ࣮ࢱ
• ᭷ຠ฼⏝ࡉࢀ࡚࠸࡞࠸ཌ⏕ປാ┬࣭ᆅ᪉ཌ⏕ᒁ࣭
㒔㐨ᗓ┴࣭೺ಖ㐃➼ࡢࢹ࣮ࢱ
• ᚲせ࡞㔠ࡢᢞධࢆ
34
38
ᆅᇦ་⒪䞉ໟᣓ䜿䜰๰⏕ᇶ㔠
• ᇶ㔠䛻䜘䜛㈈ᨻᨭ᥼䛿䚸ᆅᇦ་⒪䞉ໟᣓ䜿䜰䝡䝆䝵䞁䛾ᐇ
⌧䛻ྥ䛡䛶䚸ලయⓗ䛺ᆅᇦ་⒪ィ⏬䞉ᆅᇦໟᣓ䜿䜰ィ⏬
䛜⟇ᐃ䛥䜜䚸ィ⏬䛾ᐇຠᛶ☜ಖ䛾ᡭẁ䜒ᩚഛ䛥䜜䜛䛣䛸
䛜๓ᥦ䚹
• ⑓ᗋ㌿᥮䜔ᅾᏯᨭ᥼䜢ጞ䜑䛸䛩䜛་⒪ᶵ⬟䛾ศ໬䞉㐃ᦠ
䜢㈈ᨻᨭ᥼
• ㈈ᨻᨭ᥼䛻ᙜ䛯䛳䛶せ௳䛸䛧䛶⪃៖䛥䜜䜛ྲྀ⤌䜏䛾౛
– ᪂ᆺ་⒪ἲே䠄䝩䞊䝹䝕䜱䞁䜾䜹䞁䝟䝙䞊ᆺ䛾ἲே㢮ᆺ䠅䛾๰
タ
– ᆅᇦໟᣓ䜿䜰䜢䝧䞊䝇䛸䛧䛯䝁䝭䝳䝙䝔䜱ᙧᡂ䚸⏫䛾䜲䞁䝣䝷స
䜚䜈䛾་⒪ᶵ㛵䛾✚ᴟⓗཧຍ
– 24᫬㛫ᆅᇦᕠᅇᆺゼၥ䝃䞊䝡䝇䜈䛾ᣦྥ
35
་⒪ᶵ㛵䛾ᴗែ㌿᥮
䠄つไ⦆࿴䠅
• ་⒪ἲே䛜⑓㝔⤒Ⴀ䛾㠀Ⴀ฼ᛶ䜢ᢸಖ䛧䛴
䛴௜ᖏ஦ᴗ䛷ఫᏯᘓタ䠄䝃䞊䝡䝇௜䛝㧗㱋⪅
ఫᏯ䚸᭷ᩱ⪁ே䝩䞊䝮䠅䜔⏫䛾䜲䞁䝣䝷ᙧᡂ
䛻ཧຍ䚸ඹྠ஦ᴗ䜢❧䛱ୖ䛢䜛䛣䛸䛜䛷䛝䜛
㐨䜢㛤䛟䠄䠙䛣䜜⮬య䛿Ⴀ฼஦ᴗ䠅
• 䛭䛾㝿䛾䝣䜯䜲䝘䞁䝇䛾㑅ᢥ⫥䛸䛧䛶䚸௒ᚋ
ៅ㔜䛻タィ䛥䜜䜛䜉䛝䛂䝦䝹䝇䜿䜰REIT䛃➼䜢
ど㔝䛻ධ䜜䜛䚹
36
39
䜖䜛䜔䛛䛺䝀䞊䝖䜻䞊䝟䞊ୗ䛾
䝣䝸䞊䜰䜽䝉䝇䛾⥔ᣢ
•
•
•
•
ಖ㝤ド୍ᯛ䛷䛔䛴䛷䜒䛹䛾་⒪ᶵ㛵䜒฼⏝䛷䛝䜛䛂䝣䝸䞊䜰䜽䝉䝇䛃䛿䚸
᪥ᮏ䛾་⒪ไᗘ䛾኱䛝䛺≉ᚩ䚹ᝈ⪅䛻䛸䛳䛶䚸฼౽ᛶ䛜㧗䛔䚹ከ䛟䛾ሙ
ྜ䚸ᝈ⪅䛿䚸㔜⠜䛺⑌ᝈ䛷䛒䜜䜀⥲ྜ⑓㝔䜔ᑓ㛛⑓㝔䜢ཷデ䛧䚸᪥ᖖ
ⓗ䛺⑌ᝈ䛷䛒䜜䜀㏆䛟䛾୰ᑠ⑓㝔䜔デ⒪ᡤ䜢ཷデ䛩䜛䛸䛔䛖ཷデ⾜ື䜢
䛸䛳䛶䛔䜛䚹
䛣䜜䛻ᑐ䛧䚸䝣䝸䞊䜰䜽䝉䝇䛿䚸㐣๫䛺ᝈ⪅⋓ᚓ➇த䜔㧗㢠ᶵჾ䛾ᑟධ
ྜᡓ䜢ຓ㛗䛩䜛䛺䛹䚸་⒪㈨※඲య䛾ຠ⋡ⓗ䛺ά⏝䜢㜼ᐖ䛧䚸་⒪䛾㉁
䜢పୗ䛥䛫䛶䛔䜛䛾䛷䚸䛂ᐙᗞ་䛃ไᗘ䜢タ䛡䛶䚸䜎䛪䛿ᐙᗞ་䛷䛾デ᩿
䜢ཷ䛡䛶䛛䜙⑓㝔䛷䛾ཷデ䛜䛷䛝䜛䜘䛖䛻䛩䜉䛝䛸䛾ពぢ䛜䛒䜛䚹
䛣䜜䜎䛷ᡃ䚻䛜ாཷ䛧䛶䛝䛯䝣䝸䞊䜰䜽䝉䝇䜢ᤞ䛶ཤ䜛䝕䝯䝸䝑䝖䛿኱䛝
䛔䚹་⒪㈨※䛾ຠ⋡ⓗ䛺ά⏝䛾㜼ᐖ䜔་⒪䛾㉁䛾పୗ䛻㛵㐃䛩䜛ㄢ㢟
䛻䛴䛔䛶䛿䚸䛭䜜䛮䜜䛻ᑐᛂ䛩䜛ᡭẁ䛜䛒䜚䚸䛭䜜䛻ྲྀ䜚⤌䜐䛣䛸䛻䜘
䜚䚸䝣䝸䞊䜰䜽䝉䝇䜢⥔ᣢ䛧䛶䛔䛟䚹
䛺䛚䚸⌧⾜ไᗘ䛸ᖹ⾜䛧䛶䚸䛛䛛䜚䛴䛡⥲ྜ་➼䛜㑅ᢥไ䛷タ䛡䜙䜜䚸
௒䛾㛤ᴗ་䛸༠ຊⓗ⿵᏶ⓗ㛵ಀ䜢ᙧᡂ䛩䜛䛣䛸䛿䚸ᮃ䜎䛧䛔䛣䛸䛷䛒䜛䚹
37
䝣䝸䞊䜰䜽䝉䝇䛾ไ㝈 orㄢ㢟ẖ䛾ᑐᛂ
኱
⑓
㝔
ᣦ
ྥ
䝣䝸䞊䜰䜽䝉䝇䛾
ไ㝈䞉ᗫṆ
䝣䝸䞊䜰䜽䝉䝇䛾ୡ⏺
㈝⏝䝞䝷䞁䝇
㉁ⓗၥ㢟䠖་⒪㐃ᦠ䞉䝏䞊䝮་⒪ᙅ
38
40
䝣䝸䞊䜰䜽䝉䝇䜢Ᏺ䜛䛯䜑䛾ㅖ⟇
•
㑅ᐃ⒪㣴ෆ䛾ึデ᫬≉ᐃ⒪㣴㈝䛷䛿ຠᯝ䛜ప䛔
– ึデ᫬୍ᐃ⑓ᗋᩘ䠄౛䠖䠎䠌䠌ᗋ䠅௨ୖ䛾୍⯡⑓Ჷ䛷䛾⤂௓䛾䛺䛔እ᮶ཷデ䛻䚸୍ᐃ㢠䠄౛䠖
䠍୓෇䠅䛾ᐃ㢠⮬ᕫ㈇ᢸ䜢タ䛡䜛䚹ྠᵝ䛾௙⤌䜏䜢෌デ᫬䛻䜒᳨ウ䚹
– 䛣䛾ᐃ㢠⮬ᕫ㈇ᢸ䜢ᑟධ䛧䛯ሙྜ䚸㑅ᐃ⒪㣴ୖ䛾㈇ᢸ䛥䛘㐺⏝㝖እ䛸䛺䛳䛶䛔䜛ᩆᛴ㌴฼
⏝䛜୍ᒙ᭷฼䛻䛺䜛䛯䜑䚸ᩆᛴ㌴䛾㐺ṇ฼⏝䛻䛴䛔䛶䛿ู㏵᳨ウ䛾せ᭷䜚䚹
•
೺ಖ㐃䛛䜙䛾Ⓨゝ䛻䜒䛒䛳䛯70ṓ௨ୖ䛾㧗㢠⒪㣴㈝䚸እ᮶≉౛䛾ぢ┤䛧
– 䛂௒䛾㧗㱋⪅䚸≉䛻70ṓ௨ୖ䛾᪉䛻䛿㧗㢠⒪㣴㈝䚸እ᮶䛻䛴䛔䛶≉౛䛾ྲྀ䜚ᢅ䛔䜒䛤䛦䛔
䜎䛩䚹㠀ᖖ䛻㈇ᢸ䛜㍍䛟䛺䜛௙⤌䜏䛻䛺䛳䛶䛚䜚䜎䛩䛃
– పᡤᚓ⪅䜈䛾㓄៖䛿ᙜ↛
•
་⒪㐃ᦠ䞉䝏䞊䝮་⒪䛾᥎㐍
– 㧗䛔ᑓ㛛ᛶ䜢᭷䛧䛯㛤ᴗ་䛸䛔䛖᪥ᮏ䛾䝥䝷䜲䝬䝸䞊䜿䜰་䛾㛗ᡤ䜢䛔䛛䛧䛺䛜䜙䚸་⒪㐃
ᦠ䞉䝏䞊䝮་⒪䜢᥎㐍䛧䛶䛔䛟䚹
•
᪥ᮏᆺ⥲ྜ་䛾䛒䜚᪉䜢᳨ウ
– 䝀䞊䝖䜻䞊䝢䞁䜾ᶵ⬟䛿䜲䜼䝸䝇䛾GP䛾䜘䛖䛺䜒䛾䛷䛿䛺䛟䚸ୖ㏙䛾౯᱁䝯䜹䝙䝈䝮䜢⏝䛔䛯
⛬ᗘ䛻䛧䛶䛚䛝䚸ᝈ⪅䛻ᑐ䛧䛶୍㈏䛧䛯⑓Ṕ䚸ཷデ⾜ື䛾⟶⌮䜢⾜䛖䛸ඹ䛻䚸ᑓ㛛་䜔⑓
㝔䚸௓ㆤ㛵ಀ⪅䛸䛾㛫䛾㐃ᦠ䛾୺ᙺ䜢ᢸᙜ䛩䜛䛺䛹䚸ᝈ⪅䛸་ᖌ䛾ಙ㢗㛵ಀ䜢ᇶ㍈䛸䛧䛯
⥅⥆ⓗ䛺ಖ೺ᣦᑟ䜔⑌⑓ண㜵άື䜢⾜䛖᪥ᮏᆺ⥲ྜ་䛾䛒䜚᪉䜢᳨ウ䛩䜛䚹
•
ጤဨ䛛䜙䛾せồ
– デ⒪ሗ㓘ᨭᡶ䝕䞊䝍䜢཰㞟⟶⌮䛩䜛ᶵ㛵䜢タ䛡䚸ከ๣ᢞ୚䚸㐣๫᳨ᰝၥ㢟䛜䛒䜛䛸ᛮ䜟䜜
䜛ಖ㝤་⒪ᶵ㛵䛻䛿ᣦᑟ䜢⾜䛖䚹
39
་⒪㈝
⮬ᕫ㈇ᢸ㢠
⑓デᶵ⬟ศ໬䞉㐃ᦠ䛸
኱⑓㝔䛻䛚䛡䜛ᐃ㢠⮬ᕫ㈇ᢸ
㧗㢠⒪㣴㈝ไᗘ
་⒪㈝
ᐃ㢠⮬ᕫ㈇ᢸ
䠏๭㈇ᢸ
40
41
་⒪ಖ㝤ไᗘ
• 䛄♫఍ಖ㞀ไᗘᨵ㠉᥎㐍ἲ䛅
– ་⒪ಖ㝤ไᗘ䛻䛴䛔䛶䛿䚸㈈ᨻᇶ┙䛾Ᏻᐃ໬䚸
ಖ㝤ᩱ䛻ಀ䜛ᅜẸ䛾㈇ᢸ䛻㛵䛩䜛බᖹ䛾☜ಖ䚸
ಖ㝤⤥௜䛾ᑐ㇟䛸䛺䜛⒪㣴䛾⠊ᅖ䛾㐺ṇ໬➼䜢
ᅗ䜛䛣䛸
• ୗグ䚸䛭䜜䛮䜜䛂㈨ᩱ䛃ཧ↷
– ᚋᮇ㧗㱋⪅་⒪ไᗘ䛾⥲ሗ㓘๭䛻䛴䛔䛶
– ᅜಖ䛾㒔㐨ᗓ┴༢఩䜈䛾ᗈᇦ໬
– ᅜಖ⤌ྜၥ㢟䚸䛭䛾୰䛾་ᖌᅜಖ䛻䛴䛔䛶
41
་⒪ಖ㝤ไᗘ㛵㐃㈨ᩱ
• 䛂㧗㱋⪅་⒪ไᗘ䛻㛵䛩䜛᳨ウ఍䛃䠄2008ᖺ9
᭶24᪥䡚2009ᖺ3᭶24᪥䠅䛻䛚䛡䜛㆟ㄽ
– ᚋᮇ㧗㱋⪅་⒪ไᗘ䛾⥲ሗ㓘๭䛻䛴䛔䛶
– ᅜಖ䛾㒔㐨ᗓ┴༢఩䜈䛾ᗈᇦ໬
• ᅜಖ⤌ྜၥ㢟䚸䛭䛾୰䛾་ᖌᅜಖ䛻䛴䛔䛶
– 䛄䜻䝱䝸䜰䝤䝺䜲䞁䛅2013ᖺ1᭶6᪥㓄ಙグ஦
– 䛂་⒪ಖ㞀ᨻ⟇䛸་⒪ᅋయ䛾ᨻ἞⤒῭Ꮫⓗ఩⨨
䠄་ᖌᅜಖၥ㢟ヱᙜ⟠ᡤ䠅䛃᪥ᮏ་ᖌ఍䛄ᖹᡂ23䞉
24ᖺᗘ་⒪ᨻ⟇఍㆟ሗ࿌᭩䛅2012ᖺ1᭶
42
42
ᚋᮇ㧗㱋⪅་⒪ไᗘ䛾⥲ሗ㓘๭䛻䛴䛔䛶
• 䛂㧗㱋⪅་⒪ไᗘ䛻㛵䛩䜛᳨ウ఍䛃㆟ㄽ䛾ᩚ⌮䛻䛴
䛔䛶䠄2009ᖺ3᭶24᪥䠅
– 2008ᖺ9᭶24᪥䡚2009ᖺ3᭶17᪥ ඲7ᅇ㛤ദ
• ᅜಖ䛸⿕⏝⪅ಖ㝤䛾㛫䛿ຍධ⪅ᩘ䛷ᆒ➼䛻ศ䛡䚸⿕⏝⪅ಖ㝤
䛾୰䛷䛿䚸㈈ᨻຊ䛾ᙉ䛔ಖ㝤⪅䛜㈈ᨻຊ䛾ᙅ䛔ಖ㝤⪅䜢ᨭ᥼
䛩䜛䜒䛾䛸䛺䜛䜘䛖䚸ಖ㝤⪅䛾㈈ᨻຊ䛻ᛂ䛨䛯ᛂ⬟㈇ᢸ䛻䜘䜛ຓ
䛡ྜ䛔䞉㐃ᖏ䛾௙⤌䜏䛻䛩䜉䛝䠄඲㠃⥲ሗ㓘๭䠅䛸䛔䛖ពぢ䛜
䛒䛳䛯䚹
• 䞉䞉䞉䛣䛾㝿䚸๓ᮇ㧗㱋⪅་⒪ไᗘ䛻䛿┤᥋බ㈝䜢ᢞධ䛩䜛䛣䛸䛸
䛧䛯ሙྜ䚸ከ㢠䛾බ㈝䜢ᚲせ䛸䛧䚸䜎䛯䚸ᅜಖ䜘䜚䜒೺ಖ⤌ྜ➼
䛾㈇ᢸ䛜䜘䜚㍍ῶ䛥䜜䜛䛸ゝ䛳䛯Ⅼ䜔බ㈝䛾ᢞධ䛿ᅜಖ䜢ඃඛ
䛩䜉䛝䛸䛔䛖ពぢ䜢ྵ䜑䚸༑ศ䛻᳨ウ䛩䜛䚹
• ௒⯡䛾୍యᨵ㠉䛷䛣䜜䜙䛾ពぢ䠄඲㠃⥲ሗ㓘๭䚸ᾋ
䛔䛯බ㈝䛾ᢞධ䛿ᅜಖඃඛ䠅䛾ᐇ⌧䜢ᅗ䜛ᚲせ䚹
43
䛂㧗㱋⪅་⒪ไᗘ䛻㛵䛩䜛᳨ウ఍䛃
䛻䛚䛡䜛㆟ㄽ
• ➨䠒ᅇ㧗㱋⪅་⒪ไᗘ䛻㛵䛩䜛᳨ウ఍
䠄2009ᖺ3᭶11᪥ Ⓨゝ⪅ᶒ୔䠅
– 䛷䛩䛛䜙䚸⤌ྜ೺ಖ䛾ಖ㝤ᩱ⋡䛿᭱㧗9.62䠂䚸᭱ప
3.12䠂䛷䛒䜛䚹65ṓ௨ୖ䛾㧗㱋⪅䛻䛛䛛䜛་⒪㈝䛾
㈈ᨻㄪᩚ㒊ศ䛰䛡䛷䜒⿕⏝⪅ಖ㝤䛻ᛂ⬟㈇ᢸཎ๎
䜢ᑟධ䛩䜛䛣䛸䛻䜘䜚䚸⤌ྜ೺ಖ䛾ゎᩓ䜢ᅇ㑊䛧䚸⤌
ྜ೺ಖ䛾䝯䝸䝑䝖䜢䜘䜚ከ䛟䛾ᅜẸ䛻ாཷ䛧䛶䜒䜙䛖䚹
⚾䛿䚸⤌ྜ೺ಖ䛸䛔䛖䛾䛿㠀ᖖ䛻౯್䛜䛒䜚䚸㠀ᖖ
䛻Ⰻ䛔䛣䛸䜢䜔䛳䛶䛔䜛䛸ᛮ䛳䛶䛚䜚䜎䛩䚹䛷䛩䛛䜙䚸
䛺䜛䜉䛟䛣䛾⤌ྜ೺ಖ䛸䛔䛖䜒䛾䜢฼⏝䛷䛝䜛ே䛯䛱
䜢ቑ䜔䛩䛯䜑䛻䛿䛹䛖䛩䜜䜀䛔䛔䛛䛸䛔䛖䛣䛸䜢䜔䛿
䜚⪃䛘䛶䛔䛛䛺䛡䜜䜀䛔䛡䛺䛔䛸䛔䛖䛾䛜䚸┠ⓗ䛾
୰䛻䠍䛴ධ䛳䛶䛚䜚䜎䛩䚹
44
43
– 䛭䜜䛸䛸䜒䛻䚸䝗䜲䝒⿕⏝⪅ಖ㝤䛾་⒪ಖ㝤ᩱ⋡䛿
14.6䠂䚸䝣䝷䞁䝇13.85䠂䛷䛒䜚䚸᪥ᮏ䛾௒ᚋ䛾་⒪ಖ
㝤ᩱ⋡ᘬ䛝ୖ䛢䜢䝇䝮䞊䝈䛻⾜䛖䛣䛸䛜䛷䛝䜛䜘䛖䛻䚸
㈇ᢸຊ䛾ᙅ䛔ᒙ䛻㐣㔜䛺㈇ᢸ䛜ཬ䜀䛺䛔‽ഛ䜢䛧䛶䛚
䛟䛸䛔䛖䛣䛸䛜䚸⚾䛾㐲䛔┠ᶆ䛸䛧䛶䜒䛒䜚䜎䛩䚹䛭䛖䛔䛖
┠ⓗព㆑䛸䛔䛔䜎䛩䛛ၥ㢟ព㆑䛻❧䛳䛶䚸䛣䛾఍㆟䛾
ᙜึ䛛䜙䛪䛳䛸ゝ䛳䛶䛚䜚䜎䛧䛯䛾䛜䚸ᖺ㔠ཷ⤥㛤ጞᖺ
㱋65ṓ௨ୖ䛾ே䛯䛱䜢ᑐ㇟䛸䛧䛯㧗㱋⪅་⒪ไᗘ䛻せ
䛩䜛་⒪㈝䛸䛔䛖䛾䛿䚸ᅜಖ䛸⿕⏝⪅ಖ㝤䛾㛫䛷䛿ᆒ
➼๭䛷ศ䛡䛶䚸⿕⏝⪅ಖ㝤㈇ᢸศ䛿⥲ሗ㓘䛷๭䛳䛶䚸
ᛂ⬟㈇ᢸ䛾ಖ㝤ᩱ⋡䜢⟬ᐃ䛩䜛䚹
45
– 䛭䛾ヨ⟬䜢➨䠎ᅇ఍㆟䛷䛚㢪䛔䛧䛶䚸➨ 䠏ᅇ┠䛊2008
ᖺ12᭶4᪥䛋䛾㈨ᩱ䛸䛧䛶㓄௜䛧䛶䛔䛯䛰䛔䛯䚹ヨ⟬
䛻䜘䜜䜀䚸⿕⏝⪅ಖ㝤䛷䛿ಖ㝤ᩱ⋡3.3䠂䜢㧗㱋⪅
་⒪ไᗘྥ䛡䛾ಖ㝤ᩱ䛸䛧䛶㈇ᢸ䛩䜜䜀䚸䛣䛾ไᗘ
䛿ື䛔䛶䛔䛟䛣䛸䛻䛺䜛䚹䛭䛖䛺䜛䛸䚸ඛ䜋䛹䜒ゝ䛔䜎
䛧䛯᭱㧗9.62䠂䛸䛔䛖ಖ㝤ᩱ⋡䜢㝶ศୗ䛢䜛䛣䛸䛜䛷
䛝䛶䚸ᕝῲඛ⏕䜒䛣䛾 㛫䝔䝺䝡䛷䛚䛳䛧䜓䜙䜜䛶䛔䛯
䜘䛖䛻䚸⤌ྜ೺ಖ䛾୰䛻ᩘከ䛟䛾ே䛯䛱䜢ṧ䛩䛣䛸䛜
䛷䛝䜛䜘䛖䛻䛺䜛䚹䛭䛧 䛶䚸⤌ྜ೺ಖ䛸䛔䛖䝯䝸䝑䝖䜢
ாཷ䛷䛝䜛ᅜẸ䛾ᩘ䜢ቑ䜔䛩䛣䛸䛜䛷䛝䜛䛸䛔䛖䛣䛸
䛜䛒䜛䛾䛷䚸䛭䛖䛔䛖⪃䛘᪉䛜䛒䛳䛶䛔䛔䛾䛷䛿䛺䛔
䛛䚹
46
44
• ➨䠑ᅇ㧗㱋⪅་⒪ไᗘ䛻㛵䛩䜛᳨ウ఍
䠄2009ᖺ2᭶24᪥ Ⓨゝ⪅ᶒ୔䠅
– ⚾䛜᭱ᚋ䛻ⓙ䛥䜣䛻䜟䛛䛳䛶䛔䛯䛰䛝䛯䛔䚸グ᠈䛧䛶䛔
䛯䛰䛝䛯䛔䛾䛿䚸㈨ᩱ䠥 䠉(4)䛸䠥䠉(5)䛸䛔䛖䛾䛜䚸䛣䛾ᅜ
䛾ಖ㝤㈈ᨻ䛾⌧≧䛷䛒䜛䛸䛔䛖䛣䛸䛷䛩䚹䜋䛛䛾ᅜ䛸ẚ
䜉䛶䚸་⒪ಖ㝤ᩱ⋡䚸⿕⏝⪅ಖ㝤䛾ಖ㝤ᩱ⋡䛿䜒䛾䛩䛤
䛟ప䛔䛸䛔䛖䛣䛸䚹䛭䛧䛶䚸䛭䛾⿕⏝⪅ಖ㝤䛾୰䛷䜒ᡤᚓ
䛾㐪䛔䛻䜘䛳䛶䚸ಖ㝤ᩱ⋡ 䛜䜒䛾䛩䛤䛟㧗䛔䛸䛣䜝䛸ప䛔
䛸䛣䜝䜎䛷ᕪ䛜䛒䜚䚸䛭䛾᱁ᕪ䛿3ಸ௨ୖ䛷䛒䜛䛸䛔䛖䛣䛸
䛿䚸ᅜẸ䛾ᖖ㆑䛻䛧䛶䛔䛯䛰䛡䜜䜀䛸ᛮ䛳䛶䛚䜚 䜎䛩䚹䛣
䛾㎶䜚䛾䛸䛣䜝䛿䚸⚾䛿་⒪䛾䜏䛺䜙䛪㈈ᨻ඲య䛾ၥ㢟
䜢⪃䛘䛶䛔䛟䛸䛝䛻䚸䜎䛪኱๓ᥦ䛻⨨䛔䛶䜒䜙䛔䛯䛔䛸
ᛮ䛳䛶䛔䜎䛩䚹
47
➨5ᅇ㧗㱋⪅་⒪ไᗘ䛻㛵䛩䜛᳨ウ఍㓄௜㈨ᩱ
䠄ᶒ୔せồ㈨ᩱ 2009ᖺ2᭶24᪥㓄ᕸ䠅
48
45
➨5ᅇ㧗㱋⪅་⒪ไᗘ䛻㛵䛩䜛᳨ウ఍㓄௜㈨ᩱ
䠄ᶒ୔せồ㈨ᩱ 2009ᖺ2᭶24᪥㓄ᕸ䠅
49
➨3ᅇ㧗㱋⪅་⒪ไᗘ䛻㛵䛩䜛᳨ウ఍㓄௜㈨ᩱ
䠄ᶒ୔せồヨ⟬ 2008ᖺ12᭶4᪥㓄ᕸ䠅
50
46
ᅜಖ䛾㒔㐨ᗓ┴༢఩䜈䛾ᗈᇦ໬䐟
• ་⒪ᥦ౪యไᨵ㠉䛾ᐇຠᛶ䜢㧗䜑䜛䛯䜑䛻䛿䚸་⒪ィ⏬
䛾⟇ᐃ⪅䛷䛒䜛㒔㐨ᗓ┴䜢ᅜಖ䛾ಖ㝤⪅䛸䛩䜛䛣䛸䛻䜘
䜚䚸ಖ㝤⪅ᶵ⬟䜢㏻䛨䛯ཷ┈䛸㈇ᢸ䛾≌ไ䜢ാ䛛䛫䜛䛣䛸
䛜ຠᯝⓗ䚹
• ᚋᮇ㧗㱋⪅ᨭ᥼㔠䛾඲㠃ሗ㓘๭䛸ᅜಖ䛾㒔㐨ᗓ┴໬䚸䛥
䜙䛻䛿ᚋ㏙䛩䜛䠄55㡫ཧ↷䠅ᡤᚓ䛾㧗䛔⿕ಖ㝤⪅䛛䜙䛺䜛
ᅜಖ⤌ྜ䜈䛾ᐃ⋡⿵ຓ䛾ᗫṆ䜢୍యⓗ䛻ᐇ⌧䛩䜜䜀䚸
⿕⏝⪅ಖ㝤⪅㛫䛾䜏䛺䜙䛪ᕷ⏫ᮧ㛫䛾ಖ㝤ᩱ㈇ᢸ䛾᱁
ᕪ䛾᫝ṇ䜢ᅗ䜛䛣䛸䛜䛷䛝䜛䛣䛸䛻䛺䜚䚸ಖ㝤ไᗘ䜢㏻䛨䛶
䛂ಖ㝤ᩱ㈇ᢸ䛻ಀ䜛ᅜẸ䛾㈇ᢸ䛻㛵䛩䜛බᖹ䛾☜ಖ䛃䛸
䛾䛄♫఍ಖ㞀ไᗘᨵ㠉᥎㐍ἲ䛅䛾㊃᪨䜢ᐇ⌧䛷䛝䚸ᾘ㈝
⛯⋡ᘬୖ䛢䛾䝍䜲䝭䞁䜾䛻䜅䛥䜟䛧䛔ᨵ㠉䛸䛺䜛䚹
• 䛺䛚䚸ᕷ⏫ᮧ䛜ᘬ䛝⥆䛝㈐௵䜢ᣢ䛳䛶཰⣡ᑐ⟇䚸ಖ೺஦
ᴗ䛻ྲྀ䜚⤌䜐௙⤌䜏䜢☜ಖ䛩䜛ᚲせ䛿䛒䜛䚹
51
ᅜಖ䛾㒔㐨ᗓ┴༢఩䜈䛾ᗈᇦ໬䐠
• ➨䠑ᅇ㧗㱋⪅་⒪ไᗘ䛻㛵䛩䜛᳨ウ఍
䠄䠎䠌䠌䠕ᖺ䠎᭶䠎䠐᪥ Ⓨゝ⪅ᶒ୔䠅
– ᆅᇦ་⒪䛾䛸䛣䜝䜒䚸ᕷ⏫ᮧ䛷䛿䛺䛟䛶䚸䛔䜝䜣䛺ᗈᇦ䛸䛔䛖ᙧ
䛷⪃䛘䛶䛔䛟䛾䜒䛔䛔䚹䛯䛰䚸௒䚸ᕷ⏫ᮧ䛷䜒䛛䛺䜚෌ಖ㝤ไᗘ
䜢タ䛡䛶䛔䜛䛾䛷䚸䛭䜣䛺䛻㈈ᨻ༢఩䛜ᑠ䛥䛔䛛䜙䛸䛔䛳䛶㈈
ᨻⓗ䛻༴䛺䛔䛛䛸䛔䛖䛸䚸 䛭䛣䜙㎶䛾༴ᶵឤ䛿䚸⚾䛿䜋䛛䛾ே
䛸㐪䛖䛛䜒䛧䜜䛺䛔䜣䛷䛩䛜䚸䛯䛰䚸ᆅᇦ་⒪ィ⏬䜢సᡂ䛧䛶
䛔䜛䛾䛜㒔㐨ᗓ┴༢఩䛻䛺䛳䛶䛟䜛䛧䚸䞉䞉䞉᪉ྥᛶ䛸䛧䛶䛿䚸㒔
㐨ᗓ┴༢఩䛻ᣢ䛱㎸䜣䛷䛔䛟䛸䛔䛖䛾䛿䚸䛔䜝䜣䛺ព࿡䛷䝯䝸䝑
䝖䛿䛒䜛䛾䛷䚸䛭䛾᪉ྥ䛷⪃䛘䜎䛧䜗䛖䛸䛔䛖䛣䛸䛷䛩䚹
䛭䜜䛸䜒䛖୍䛴䚹ᅜᗜ㈇ᢸ䜢ධ䜜䜛䛸䛝䛻䚸㈈ᨻㄪᩚไᗘ䛾
୰䛻ᅜᗜ㈇ᢸ䜢ධ䜜䜛䛸䛔䛖䛣䛸䛿䚸ᅜಖ䛾ಖ㝤ᩱ䜢䜋䛸䜣䛹
㍍ῶ䛧䛺䛔䛸䛔䛖䛣䛸䜢௒᪥䛚ヰ䛧䛧䜎䛧䛯䚹䛣䜜䜢ᅜಖ䛾୰䛻
䝎䜲䝺䜽䝖䛻ᢞධ䛧䛶䚸పᡤᚓ⪅䛾ಖ㝤ᩱ䜢㍍ῶ䛩䜛䛸䛔䛖ᙧ
䛷పᡤᚓ⪅ᑐ⟇䛸䛧䛶㞟୰ⓗ䛻ᅜᗜ㈇ᢸ䜢ᢞධ䛩䜛䛸䛛䛔䛖
䛾䛷䛧䛯䜙䚸⚾䛿኱䛔䛻ᨭᣢ䛩䜛䛸䜒ゝ䛳䛶䛝䛯䜟䛡䛷䛩䚹
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• ➨䠒ᅇ㧗㱋⪅་⒪ไᗘ䛻㛵䛩䜛᳨ウ఍
䠄2009ᖺ3᭶11᪥Ⓨゝ䠅
– ᅜಖ䛸䛔䛖䛾䛿┴༢఩䛷⪃䛘䛶䛔䛟 䛸䛔䛖ி㒔ᗓ䛾
▱஦䜒䛚䛳䛧䜓䜙䜜䛶䛔䛯ᙧ䛷㐍䜣䛷Ⰻ䛔䛾䛷䛿䛺
䛔䛛䛸⪃䛘䛶䛚䜚䜎䛧䛶䚸䛷䛝䜜䜀ᅜᗜ㈇ᢸ䜢ᢞධ䛩
䜛䛸䛔䛖䛣䛸䛷䛒䜛䛾䛺䜙䜀䚸䛣䛾ᅜಖ䛻┤᥋ᅜᗜ㈇
ᢸ䜢ᢞධ䛧䛶䚸ྍ⬟䛺㝈䜚పᡤᚓ⪅ 䛾㈇ᢸ䜢㍍ῶ䛩
䜛䜘䛖䛺௙⤌䜏䛷ᅜᗜ㈇ᢸ䜢ᢞධ䛧䛶䛔䛟䛸䛔䛖᪉䛜
ඃඛ㡰఩䛜㧗䛟䛺䛳䛶䛟䜛䚹䛣䛾๓䛾 䜘䛖䛻㧗㱋⪅ไ
ᗘ䛾๓ᮇ䛾䛸䛣䜝䛻ᅜᗜ㈇ᢸ2.4඙෇䜢ධ䜜䜛䛸䛔䛖
䛣䛸䛿ᑗ᮶䛒䜛䛸䛧䛶䜒䚸ඃඛ㡰఩䛿 䛛䛺䜚ప䛔ヰ䛷
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54
䠆௒⯡䛾୍యᨵ㠉䛾ᯟእ䛻䛒䜛䚸⿕⏝⪅ಖ㝤䛾65ṓ௨ୖ⿕ᢇ㣴⪅䛻ಀ䜛๭ቑಖ㝤ᩱ⋡䚸⮬ᕫ㈇ᢸ䛻㛵䛩䜛グ㏙䛿እ䛧䛶䛔䜛䚹
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ᅜಖ⤌ྜၥ㢟䚸䛭䛾୰䛾་ᖌᅜಖ䛻䛴䛔䛶
• ᅜಖ⤌ྜ䛾Ꮡᅾ⌮⏤䛿䛺䛔䚹ᅜಖ⤌ྜ䛾୍
䛴་ᖌᅜಖ䛿⋡ඛ䛧䛶ゎᩓ䛧䚸་⒪⪅䛿་
ᴗ೺ಖ䜈
– 䛄䜻䝱䝸䜰䝤䝺䜲䞁䛅2013ᖺ1᭶6᪥㓄ಙグ஦
– 䛂་⒪ಖ㞀ᨻ⟇䛸་⒪ᅋయ䛾ᨻ἞⤒῭Ꮫⓗ఩⨨
䠄་ᖌᅜಖၥ㢟ヱᙜ⟠ᡤ䠅䛃᪥ᮏ་ᖌ఍䛄ᖹᡂ23䞉
24ᖺᗘ་⒪ᨻ⟇఍㆟ሗ࿌᭩䛅2012ᖺ1᭶
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௓ㆤಖ㝤ᨵ㠉䛾ᚲせᛶ
• 䛄♫఍ಖ㞀ไᗘᨵ㠉᥎㐍ἲ䛅
• 䠄ᇶᮏⓗ䛺⪃䛘᪉䠅
– ♫఍ಖ㞀䛾ᶵ⬟䛾඘ᐇ䛸⤥௜䛾㔜Ⅼ໬ཬ䜃ไᗘ䛾㐠Ⴀ
䛾ຠ⋡໬䛸䜢ྠ᫬䛻⾜䛔䚸⛯㔠䜔♫఍ಖ㝤ᩱ䜢⣡௜䛩䜛
⪅䛾❧ሙ䛻❧䛳䛶䚸㈇ᢸ䛾ቑ኱䜢ᢚไ䛧䛴䛴䚸ᣢ⥆ྍ⬟
䛺ไᗘ䜢ᐇ⌧䛩䜛䛣䛸䚹
• 䠄௓ㆤಖ㝤ไᗘ䠅
– ᨻᗓ䛿䚸௓ㆤಖ㝤䛾ಖ㝤⤥௜䛾ᑐ㇟䛸䛺䜛ಖ೺་⒪
䝃䞊䝡䝇ཬ䜃⚟♴䝃䞊䝡䝇䠄௨ୗ䛂௓ㆤ䝃䞊䝡䝇䛃䛸䛔
䛖䚹䠅䛾⠊ᅖ䛾㐺ṇ໬➼䛻䜘䜛௓ㆤ䝃䞊䝡䝇䛾ຠ⋡໬ཬ
䜃㔜Ⅼ໬䜢ᅗ䜛䛸䛸䜒䛻䚸పᡤᚓ⪅䜢䛿䛨䜑䛸䛩䜛ᅜẸ䛾
ಖ㝤ᩱ䛻ಀ䜛㈇ᢸ䛾ቑ኱䜢ᢚไ䛧䛴䛴ᚲせ䛺௓ㆤ䝃䞊
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49
せᨭ᥼⪅䛾௓ㆤ⤥௜⠊ᅖ䛾㐺ṇ໬
• ㍍ᗘ䛾㧗㱋⪅
ᆅᇦໟᣓ䜿䜰䛸୍య䛸䛺䛳䛯஦ᴗ䛻⛣⾜
⌧≧
せ௓ㆤ⪅
せᨭ᥼⪅
ಶู⤥௜
ಶู⤥௜
䠄ᅜ䛜ᐃ䜑䜛୍ᚊ䛾⤥௜䚸ᇶ
‽䚸ሗ㓘䠅
䠄ᅜ䛜ᐃ䜑䜛୍ᚊ䛾⤥௜䚸ᇶ‽䚸ሗ㓘䠅
㐺ṇ໬᱌
ಖ㝤⤥௜䛛
䜙⛣⾜
ಶู⤥௜
ᆅᇦໟᣓ䜿䜰ィ⏬䛸
୍య䛸䛺䛳䛯஦ᴗ
䠄ᅜ䛜ᐃ䜑䜛୍ᚊ䛾⤥௜䚸ᇶ‽䚸ሗ㓘䠅
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䛭䛾௚㔜せ䛺ㄢ㢟
• 䛄♫఍ಖ㞀ไᗘᨵ㠉᥎㐍ἲ䛅
– ♫఍ಖ㞀䛾ᶵ⬟䛾඘ᐇ䛸⤥௜䛾㔜Ⅼ໬ཬ䜃ไᗘ䛾㐠Ⴀ
䛾ຠ⋡໬䛸䜢ྠ᫬䛻⾜䛔䚸⛯㔠䜔♫఍ಖ㝤ᩱ䜢⣡௜䛩䜛
⪅䛾❧ሙ䛻❧䛳䛶䚸㈇ᢸ䛾ቑ኱䜢ᢚไ䛧䛴䛴䚸ᣢ⥆ྍ⬟
䛺ไᗘ䜢ᐇ⌧䛩䜛䛣䛸䚹
• ᨻ⟇ᇶ‽ୖ䛾䛂పᡤᚓ⪅䛃䛿䚸ᚲ䛪䛧䜒䛂㈇ᢸ⬟ຊ䛾
ప䛔⪅䛃䛷䛿䛺䛔䚹⌧⾜䛾䛂పᡤᚓ⪅䛃ᴫᛕ䛿ㄢ⛯ᡤ
ᚓ䛾䜏䛻౫ᣐ䛧䛶䛚䜚䚸ไᗘ㐠Ⴀ䛾ຠ⋡໬䛸⛯䞉♫఍
ಖ㝤ᩱ䜢⣡௜䛩䜛❧ሙ䛻❧䛳䛯୧ほⅬ䛛䜙䛾ぢ┤䛧
䛿᭱㔜せㄢ㢟䚹
• ㄢ⛯ᡤᚓ䠙཰ධ䞊⤒㈝䞊㠀ㄢ⛯ᡤᚓ䞊᥍㝖
• ㄢ⛯ᡤᚓ䛷 䜛䛂పᡤᚓ⪅䛃䛸䛂㈇ᢸ⬟ຊ䛾ప䛔⪅䛃
䛾㛫䛻⌧Ꮡ䛩䜛䜼䝱䝑䝥䜢ᇙ䜑䜛ດຊ䜢䜒䛳䛸⾜䛖䜉
䛝䚹
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