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基礎研究
開発途上国のレベルに応じた
日本の病院施設・技術の適用
基礎研究報告書
平成 28 年 6 月
(2016 年)
独立行政法人
国際協力機構（JICA）
共同企業体
株式会社 山下設計
シップヘルスケアリサーチ＆コンサルティング株式会社
資金
ＪＲ
16-026
iii
28 6
v
.................................................................................................. 1 1. .................................................................................................................... 1 2. ........................................................................................................................... 1 3. ........................................................................................................................... 1 4. ........................................................................................................................... 2
............................................................................................................. 4 1-1 ............................................................ 4
(1) ..................................................................... 4 (2) ..................................................................... 8 (3) ............................................................................ 9
1-2 ....................................................................................... 11 (1) ................................................................ 13 (2) .......................................... 20
.................................................................................. 25 2-1 ..................................................................................................... 25 2-2 ODA ................................................................ 32 2-3 UHC .............................................................................. 33
......................................................................................... 37 3-1 ................................................................................ 37 3-2 ......................................................................................................... 39
(1) ..................................................................................................................... 39 (2) ..................................................................................................................... 41 (3) ..................................................................................................................... 41 (4) ............................................................................................................................ 43
......................................................... 45 4-1 ............................................................................................................ 45 4-2 .................................................................................................................... 46 4-3 ................................................................................................................ 49
(1) ....................................................................................................... 49 (2) ................................................................................................... 50 (3) ....................................................................... 51
.................................................................................. 52 5-1 ........................................................................................................................... 52 5-2 ........................................................................................................................... 53 5-3 ................................................................................................................ 53 5-4 ....................................................................................... 55
(1) ................................................................................................ 55 (2) ..................................................................................................................... 56 (3) .................................................................................................................. 56 (4) ....................................................................................................... 56 (5) .............................................................................................................. 57
5-5 IT .................................................................................................... 57 (1) .............................................................................. 57 (2) .......................................... 58 (3) ................................................. 59 (4) ..................................................... 59 (5) ....................................................................... 60 (6) ....................................................................... 60
5-6 .................................................................. 61 (1) Medical Excellence JAPAN ................................................ 61
vi
(2) (AMED) ............................. 61 (3) (NEDO) ......... 61
6 2 3 ................................. 63 6-1 - ...................................................... 65
(1) 2 3 ..................................................................... 65 (2) ....................................................................................................... 65 (3) ............................ 66
6-3 - .................... 67 6-4 - ............................................................. 68 6-5 - ............................................... 69
1 ..................................................................................... 71 2 ......................................................... 73 3 ......................................................................................... 75 4 ......................................................... 77
-1. 3 .......................................................................................... 2 -2. ..................................................................................................... 5 -3. ....................................................................... 12 -4. ................................................................... 15 -5. ........................................................................ 17 -6. .............................................................................. 18 -7. ................................................................ 19 -8. ....................................... 19 -9. ............................................................................................ 26 -10. ....................................................................... 28 -11. .................................................................................. 29 -12. ................................................................................................ 30 -13. ................................................................ 31 -14. .............................................................................. 32 -15. .............................................................................................................. 34 -16. .......................................................................... 35 -17. .......................................................................... 35 -18. ................................................................................................ 38 -19. ................................................................... 39 -20. ......................................................... 40 -21. .............................................................................. 41 -22. ......................................................................................... 42 -23. ................................................................... 45 -24. ......................................................... 47 -25. ................................................................................................... 49 -26. .............................................................................. 49 -27. .............................................................................. 50 -28. .......................................................................... 51 -29. ..................................................................................... 57 -30. .............................................................................. 58 -31. .............................................................................. 64 -32. ................................ 67 -33. ................................................................................................... 69
vii
BPJS Badan Penyelenggara Jaminan Sosial Kesehatan
CDC Centers for Disease Control and Prevention
CPF Central Provident Fund
CSMBS Civil Servant Medical Benefit Scheme
CSR Corporate Social Responsibility
CT Computed Tomography
DPC Diagnosis Procedure Combination
EBM Evidence Based Medicine
GDP Gross Domestic Product
HEPA High Efficiency Particulate Air
ICU Intensive Care Unit
IT Information technology
JKN Jaminan Kesehatan Nasional
LDC Less Developed Countries
LEED Leadership in Energy & Environmental Design
LLDC the Least among less Developed Countries
MEJ Medical Excellence JAPAN
MRI Magnetic Resonance Imaging
NGO non-governmental organizations
ODA Official Development Assistance
OECD Organisation for Economic Co-operation and Development
OTTV Overall Thermal Transfer Value
PACS Picture archiving and communication system
PBI Penerima Bantuan Iuran
PDF Portable Document Format
PFM Patient Flow Management
PHC Primary Health Care
PHS Personal Handyphone System
RTTV Roof Thermal Transfer Value
SET Stock Exchange of Thailand
SJSN Sistem Jaminan Sosial Nasional
SSS Social Security Scheme
STEP Special Terms for Economic Partnership
UC Universal Coverage
UHC Universal Health Coverage
WHO World Health Organization
JICA
JICA
1
1.
2.
3.
2
4.
3
4
1-1
(1)
5 2000
6.4 2000 4.3
4 1.8m 2.1m
2.7m 2000 1.2m 1.6m 1
16 1 3 1 70 1
5
7
8
(2)
8
6.4 8
15 20 6.4
5020 30
60 1
50 60 30 40
9
(3)
10
11
2
DPC
1-2
12
13
(1)
14
15
16
17
18
19
2014 (Medisave)
20
(Medishield) (Medishield Life)
(2)
21
22
23
24
25
2-1
26
27
28
29
30
31
1
2
3
4
5
6
7
8
9
32
2-2 ODA
33
2-3 UHC
34
2015 2050 7 349 472 9 725 148 1 251 351 1 286 422 6 098 121 8 438 726 954 158 1 896 921
5 143 963 6 541 805 4 690 815 7 060 907
HIC 1 401 479 1 512 496 MIC 5 306 283 6 822 476
UMIC 2 390 125 2 621 635 LMICs 2 916 158 4 200 842
LIC 638 735 1 386 201
35
752 1251 166% 39% 40%East Asia & Pacific 313 589 188% 16% 19%Europe & Central Asia 725 1309 181% 37% 42%Latin America & Caribbean 477 848 178% 24% 27%Middle East & North Africa 891 1179 132% 46% 38%South Asia 136 321 236% 7% 10%Sub-Saharan Africa 140 263 188% 7% 8%High income: OECD 2362 3832 162% 121% 123%Low income 49 102 208% 3% 3%Lower middle income 164 310 189% 8% 10%Upper middle income 448 861 192% 23% 28%High income 1949 3112 160% 100% 100%
-20 40 60 80
100
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Lower middle income
Heavily indebted poor countries (HIPC)Least developed countries: UN classificationLow income
-
200
400
600
800
1,000
1,200
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
WorldHigh income: nonOECDUpper middle incomeMiddle income
36
37
3-1
38
39
3-2
(1)
40
41
(2)
(3)
42
43
(4)
44
45
4-1
2 3
3
10
46
3-4
12
4-2
47
48
49
4-3
(1)
50
(2)
51
(3)
52
5-1
UHC
IT IT
53
5-2
5-3
54
55
5-4
(1)
56
(2)
(3)
(4)
57
(5)
5-5 IT
(1)
145,679 4.6% 152,963 5.0% 160,611 5.0%102,377 4.6% 105,061 2.6% 108,213 3.0%
24,325 3.2% 26,364 8.2% 27,273 3.6%16,119 14.7% 18,376 14.0% 20,856 13.5%
( )7,972 7.9% 8,371 5.0% 8,957 7.0%
USD Millions2013 2014 ( ) 2015 ( )
21,446 4.6% 22,946 6.5% 25,011 8.3%
58
(2)
Top 40 Medical Device Companies
2 General Electric Co. $ 790 million 24%3 $ 710 million 21%
1 Siemens $ 870 million 26%
$ 3,360 million 100%
4 Phillips Electrics $ 670 million 20%5 $ 250 million 7%
$ 70 million 2%
$ 1,310 million 23%$ 5,770 million 100%
3Phillips Electrics
$ 730 million 13%
5 Siemens $ 480 million 8%
2General Electric Co.
$1,140 million 20%
1 Siemens $ 1,110 million
1 $ 1,570 million 27%
4 $ 540 million 9%
38%2 Phillips Electrics $ 710 million 24%3 General Electric Co. $ 640 million 22%
$ 130 million 4%$ 2,940 million 100%
4 $ 180 million 6%5 Esaote $ 170 million 6%
medical device and diagnostic industry capital iq and company data by MDDI Staffon November 21, 2014
40 Dragerwerk AG & Co. KGa6 $2.0 billion $1.4 billion
Medtronic Inc.
38 Intuitive Surgical Inc. $2.1 billion $16.6 billion39 MIRACA Holdings Inc. $2.0 billion $2.4 billion
36 Danaher Corp. 5 $2.1 billion $38.6 billion37 Edwards Lifesciences $2.1 billion $11.0 billion
34 Coloplast A/S $2.2 billion $17.9 billion35 Sonova Holdings $2.2 billion $10.4 billion
32 Hologic Inc. $2.5 billion $6.6 billion33 Nipro Corp. $2.3 billion $1.4 billion
30 Ship Healthcare Holdings Inc. $2.5 billion $1.3 billion31 Paul Hartmann AG $2.5 billion $1.4 billion
28 Varian Medical Systems Inc. $3.0 billion $8.3 billion29 DENTSPLY International Inc. $3.0 billion $6.4 billion
26 Bayer AG3 $3.2 billion $115.0 billion27 CR Bard Inc. $3.1 billion $10.6 billion
24 Getinge AB $3.8 billion $6.0 billion25 Olympus Corp. $3.7 billion $11.7 billion
22 Toshiba Corp. $3.9 billion $17.6 billion23 CareFusion Corp. $3.8 billion $9.2 billion
20 Terumo Corp. $4.7 billion $9.0 billion21 Smith & Nephew plc $4.4 billion $14.9 billion
18 Abbott Laboratories2 $5.5 billion $61.9 billion19 Zimmer Holdings Inc. $4.7 billion $17.0 billion
16 St. Jude Medical Inc. $5.6 billion $17.2 billion17 3M Co. $5.5 billion $84.0 billion
14 Essilor International SA $7.2 billion $22.9 billion15 Allergan Inc. $6.7 billion $53.4 billion
12 Becton, Dickinson and Co. $8.3 billion $21.8 billion13 Boston Scientific Corp. $7.2 billion $15.6 billion
10 Covidien plc $10.4 billion $40.1 billion11 Stryker Corp. $9.3 billion $30.8 billion
8 Cardinal Health Inc. $11.0 billion $25.1 billion9 Novartis AG1 $10.7 billion $227.5 billion
6 Fresenius Medical Care AG & Co. KGAA $15.2 billion $21.1 billion7 Koninklijke Philips NV $11.8 billion $26.1 billion
4 Siemens AG $17.0 billion $92.2 billion5 Baxter International Inc. $16.4 billion $38.7 billion
2 General Electric Co. $18.1 billion $243.6 billion3 $17.1 billion $61.2 billion
Company Name Total Revenue MarketCapitalization
1 Johnson & Johnson $28.7 billion $294.2 billion
Rank
59
(3)
(4)
60
(5)
(6)
61
5-6
(1) Medical Excellence JAPAN
(2) (AMED)
(3) (NEDO)
62
63
6 2 3
2 3
64
65
6-1 -
(1) 2 3
(2)
66
(3)
67
A
B
C
6-3 -
68
6-4 -
69
6-5 -
/
/
S
10
71
1
73
2
75
3
JICA
JICA
JICA
3-1
JICA
JICA
3-2
JICA
JICA
3-3
77
4
JICA
JICA
HEPA ,
JICA
4 - 1
:
4 - 1
