平原 憲道 (ヒラハラ ノリミチ)

Hirahara, Norimichi

写真a

所属(所属キャンパス)

医学部 医療政策・管理学教室 (信濃町)

職名

助教(有期)

HP

プロフィール 【 表示 / 非表示

  • カリフォルニア大学バークレー校心理学部(認知心理学)卒業。 東京工業大学大学院社会理工学研究科博士課程修了。 英国シェフィールド大学医学部客員研究員、東京大学大学院医学系研究科を経て、慶應義塾大学医学部医療政策・管理学教室にて研究と教育に従事。

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  • 博士(学術), 東京工業大学, 課程

 

研究分野 【 表示 / 非表示

  • 統計科学

  • 認知科学

  • 生命・健康・医療情報学

研究キーワード 【 表示 / 非表示

  • MDM

  • JDM

  • 医療ビッグデータ

  • 医療意思決定

  • 意思決定科学

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著書 【 表示 / 非表示

  • 「患者中心」で成功する病院大改造: 医療の質を向上させる15章

    平原 憲道, 医学書院, 2016年06月

     概要を見る

    患者中心の医療のモデルとして知られている米国「プレイントゥリーモデル」の考え方と,導入した医療施設の概要をまとめたもの.患者中心の医療に求められる要素とは何か,医療の質を向上させるためのケアはどういったものか,実践も含めて解説.さらに,病院経営の視点からみた「患者中心の医療」,医療者と患者の関係,医療の質と安全性等にも言及.患者のための病院づくりに応用可能な事例も掲載.(Amazon.co.jpより)

  • 患者と減らそう医療ミス 患者は安全パートナー

    平原 憲道, エルゼビア・ジャパン, 2005年07月

  • みんなの「こんな病院あったらいいな」が実現する本

    平原 憲道、和田 ちひろ、武藤 正樹, 日総研出版, 2001年09月

     概要を見る

    本書は、「医療サービスという協働作業プロセス」を意味あるものにするために、「関係づくり」という新しいマーケティングの考え方を医療現場で使うことを提案し、その理論の紹介からプロセスの分析、そして現場での応用までを統合的にまとめたものである。(Amazon.co.jpより)

論文 【 表示 / 非表示

  • Current status of cardiovascular surgery in Japan, 2015 and 2016: a report based on the Japan Cardiovascular Surgery Database. 1—congenital heart surgery

    Hirata Y., Hirahara N., Murakami A., Motomura N., Miyata H., Takamoto S.

    General Thoracic and Cardiovascular Surgery (General Thoracic and Cardiovascular Surgery)  67 ( 9 ) 731 - 735 2019年09月

    ISSN  18636705

     概要を見る

    © 2019, The Japanese Association for Thoracic Surgery. Objectives: We analyzed the mortality and morbidity of congenital heart surgery in Japan by using Japan Cardiovascular Surgery Database (JCVSD). Methods: The data on congenital heart surgery performed between January 2015 and December 2016 were obtained from JCVSD. From the data obtained, the most frequent 20 procedures were selected, and the mortalities and major morbidities were analyzed. In addition, the institutions were classified into three groups according to the number of cardiopulmonary cases for a year, and the distribution of the major operations was calculated. Results: The mortality of ASD repair and VSD repair was under 1% and the mortality of TOF repair, complete AVSD repair, Rastelli operation, CoA complex repair, bidirectional Glenn and TCPC was 2–3%. The mortality of Norwood procedure and TAPVC repair were over 10%. These difficult operations were mainly performed at relatively high-volume institutions. Conclusion: Using the data from JCVSD, the national data of congenital heart surgery, including postoperative complications, were analyzed. Neonatal surgery still has considerable complication rates and further improvement is desired. In addition, it was shown that complicated operations tended to be performed at large volume institutions.

  • Current status of cardiovascular surgery in Japan: analysis of data from Japan Cardiovascular Surgery Database in 2015, 2016. 3—Valvular heart surgery

    Abe T., Nakano K., Hirahara N., Motomura N., Miyata H., Takamoto S.

    General Thoracic and Cardiovascular Surgery (General Thoracic and Cardiovascular Surgery)  67 ( 9 ) 742 - 749 2019年09月

    ISSN  18636705

     概要を見る

    © 2019, The Japanese Association for Thoracic Surgery. Objectives: Data related to valvular heart surgeries from the Japan Cardiovascular Surgery Database in 2015 and 2016 were analyzed to demonstrate the associated mortality and morbidity rates and choice of surgical procedures. Methods: We used the Japan Cardiovascular Surgery Database to extract data related to cardiac valve replacement procedures performed in 2015 and 2016. The cases were further evaluated depending upon the type of procedure and prosthesis used at each site. The percentage of bio-prosthesis usage was calculated for each valve position and age group. The rates of operative mortality and morbidity were calculated for each valve position and type of procedure. Results: Overall, 26,054 aortic valve replacements were performed in 2015 and 2016, showing a slightly larger number than the last report (2013–2014). A total of 3305 transcatheter aortic valve replacements, 5652 mitral valve replacements and 12,024 mitral valve repair procedures were performed. The percentage of bio-prosthesis usage in aortic valve replacement was 96.5, 92.7, and 63.5% for patients in their 80s, 70s, and 60s, respectively, demonstrating an increase in usage since 2013–2014. Mechanical valves were preferred in patients on chronic hemodialysis. The mortality rates of aortic valve replacement, mitral valve replacement, mitral valve repair, and tricuspid valve replacement procedures were 4.1, 7.1, 2.2, and 10.5%, respectively. Conclusion: We evaluated recent trends in valvular heart surgery in Japan with respect to the type of procedure and prosthesis preferred and the postoperative outcomes. We found that bio-prosthesis usage was becoming more common.

  • Current status of cardiovascular surgery in Japan, 2015 and 2016: analysis of data from Japan Cardiovascular Surgery Database. 4―Thoracic aortic surgery

    Shimizu H., Hirahara N., Motomura N., Miyata H., Takamoto S.

    General Thoracic and Cardiovascular Surgery (General Thoracic and Cardiovascular Surgery)  67 ( 9 ) 751 - 757 2019年09月

    ISSN  18636705

     概要を見る

    © 2019, The Japanese Association for Thoracic Surgery. Background: Thoracic and thoracoabdominal aortic diseases are treated using operative procedures like open aortic repair (OAR), thoracic endovascular aortic repair (TEVAR), or hybrid aortic repair (HAR), or a combination of OAR and TEVAR. The surgical approach to aortic repair has evolved over the decades. The purpose of this study was to examine the current trends in treatment. Methods: We extracted nationwide data of aortic repair procedures performed in 2015 and 2016 from the Japan Cardiovascular Surgery Database (JCVSD). In addition to estimating the number of cases, we also reviewed the respective operative mortalities and associated major morbidities (e.g., stroke, spinal cord insufficiency, and renal failure) according to disease pathology (e.g., acute dissection, chronic dissection, ruptured aneurysm, and unruptured aneurysm), site of operative repair (i.e., aortic root, ascending aorta, aortic root to arch, aortic arch, descending aorta, and thoracoabdominal aorta), and the preferred surgical approach (i.e., OAR, HAR, or TEVAR). Results: The total number of cases studied was 35,427, with an overall operative mortality rate of 7.3%. Among the 3 procedures, 64% of patients were treated with OAR. Compared to the data from our previous report (also derived from the JCVSD in 2013 and 2014), the total number of cases and number of OAR, HAR, and TEVAR procedures have increased by 17.0%, 2.4%, 126.1%, and 34.9%, respectively. While the overall stroke rates following aortic arch surgical repair with HAR, OAR, and TEVAR were 10.1%, 8.4%, and 7.3%, respectively, OAR was found to have the lowest stroke rate when limited to cases presenting with a non-dissected/unruptured aorta. The incidence rates of paraplegia following descending/thoracoabdominal aortic surgical repair using HAR, OAR, and TEVAR were 6.3%/10.4%, 4.3%/8.9%, and 3.4%/4.6%, respectively. TEVAR was found to be associated with the lowest incidence of postoperative renal failure. Conclusions: The number of operations for thoracic and thoracoabdominal aortic diseases has increased, though the rate of operations using an OAR approach has decreased. While TEVAR showed the lowest mortality and morbidity rates, OAR demonstrated the lowest postoperative stroke rate for non-dissecting aortic arch aneurysms.

  • Current Status of cardiovascular surgery in Japan, 2015 and 2016: a report based on the Japan Cardiovascular Surgery Database. 2—Isolated coronary artery bypass grafting surgery

    Saito A., Hirahara N., Motomura N., Miyata H., Takamoto S.

    General Thoracic and Cardiovascular Surgery (General Thoracic and Cardiovascular Surgery)  67 ( 9 ) 736 - 741 2019年09月

    ISSN  18636705

     概要を見る

    © 2019, The Japanese Association for Thoracic Surgery. Data on isolated coronary artery bypass grafting (CABG) performed in 2015 and 2016, and registered in the Japan Cardiovascular Surgery Database were reviewed for preoperative characteristics, postoperative outcomes, and choice of graft material for the left anterior descending artery (LAD). Isolated CABG was performed off-pump in 55.0% (n = 16,173) of all CABG cases (n = 29,392), and graft material for the LAD was positioned at the internal thoracic artery in 72.1% and at the right internal thoracic artery in 17.4% of patients. Operative mortality was 1.7% in elective cases, 8.8% in emergency cases, and 3.0% overall, which was similar to our previous report. In elective cases, operative mortality was 1.1% for off-pump CABG compared with 2.5% for on-pump CABG, and all morbidities except for “readmission < 30 days” were significantly better in OPCAB cases.

  • Current status of cardiovascular surgery in Japan 2013 and 2014: A report based on the Japan Cardiovascular Surgery Database. 2: Congenital heart surgery

    Hirata Y., Hirahara N., Murakami A., Motomura N., Miyata H., Takamoto S.

    General Thoracic and Cardiovascular Surgery (General Thoracic and Cardiovascular Surgery)  66 ( 1 ) 4 - 7 2018年01月

    ISSN  18636705

     概要を見る

    © 2017, The Japanese Association for Thoracic Surgery. Objectives: We analyzed the mortality and morbidity of congenital heart surgery in Japan using the Japan Cardiovascular Surgery Database (JCVSD). Methods: Data regarding congenital heart surgery performed between January 2013 and December 2014 were obtained from JCVSD. The 20 most frequent procedures were selected and the mortality rates and major morbidities were analyzed. Results: The mortality rates of atrial septal defect repair and ventricular septal defect repair were less than 1%, and the mortality rates of tetralogy of Fallot repair, complete atrioventricular septal defect repair, bidirectional Glenn, and total cavopulmonary connection were less than 2%. The mortality rates of the Norwood procedure and total anomalous pulmonary venous connection repair were more than 10%. The rates of unplanned reoperation, pacemaker implantation, chylothorax, deep sternal infection, phrenic nerve injury, and neurological deficit were shown for each procedure. Conclusion: Using JCVSD, the national data for congenital heart surgery, including postoperative complications, were analyzed. Further improvements of the database and feedback for clinical practice are required.

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総説・解説等 【 表示 / 非表示

受賞 【 表示 / 非表示

  • 日本認知科学会学会賞(特別賞)

    2012年12月, 日本認知科学会

     説明を見る

    「乳がん患者の示す治療リスク認知の楽観性 ~闘病ステージによる変化」にて受賞

 

担当授業科目 【 表示 / 非表示

  • メディカル・プロフェッショナリズムⅤ

    2019年度

  • 医療政策・管理学

    2019年度