Development of Casemix Based Evaluation System in Japan

Matsuda, Shinya; Fujimori, Kenji; Fushimi, Kiyohide

doi:10.7223/apjdm.4.55

Cited by 44 publications

(48 citation statements)

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“…These 37 hospitals had capacities of < 200 beds (1 hospital), 200-399 beds (12 hospitals), and > 400 beds (24 hospitals). The administrative claims data and discharge summary data were based on the diagnostic procedure combination/per-diem payment system (DPC/PDPS) [24]. The DPC data included patient information regarding baseline characteristics (e.g.…”

Section: Study Design and Settingmentioning

confidence: 99%

Antimicrobial utilization and antimicrobial resistance in patients with haematological malignancies in Japan: a multi-centre cross-sectional study

Mimura

Fukuda

Akazawa

2020

Ann Clin Microbiol Antimicrob

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Background: Infection is a major complication for patients with haematological malignancies. It is important to better understand the use of antimicrobial agents and antibiotic resistance for appropriate treatment and prevention of drug resistance. However, very few multi-centre analyses have focused on the use of antimicrobial agents and antibiotic resistance have been carried out in Japan. This study aimed to describe the characteristics of the use of antimicrobial agents and antibiotic resistance in patients with haematological malignancies. Methods:We conducted a cross-sectional study using administrative claims data and antimicrobial susceptibility data in Japan. We included patients diagnosed with haematological malignancies, who were hospitalized in a haematology ward between 1 April 2015 and 30 September 2017 in 37 hospitals. Descriptive statistics were used to summarize patient characteristics, antimicrobial utilization, bacterial infections, and antibiotic resistance. Results:In total, 8064 patients were included. Non-Hodgkin lymphoma (50.0%) was the most common malignancy. The broad-spectrum antibiotics displayed a following antimicrobial use density (AUD): cefepime (156.7), carbapenems (104.8), and piperacillin/tazobactam (28.4). In particular, patients with lymphoid leukaemia, myeloid leukaemia, or myelodysplastic syndromes presented a higher AUD than those with Hodgkin lymphoma, non-Hodgkin lymphoma, or multiple myeloma. The most frequent bacterial species in our study cohort was Escherichia coli (9.4%), and this trend was also observed in blood specimens. Fluoroquinolone-resistant E. coli (3.6%) was the most frequently observed antibiotic-resistant strain, while other antibiotic-resistant strains were rare. Conclusions:Broad-spectrum antibiotics were common in patients with haematological malignancies in Japan; however, antibiotic-resistant bacteria including carbapenem-resistant or multidrug-resistant bacteria were infrequent. Our results provide nationwide, cross-sectional insight into the use of antimicrobial agents, prevalence of bacteria, and antibiotic resistance, demonstrating differences in antimicrobial utilization among different haematological diseases. Chemotherapy, n (%) 6542 (81.1) Febrile neutropenia, n (%) 1100 (13.6) G-CSF, n (%) 4039 (50.1) Central venous catheter, n (%) 3072 (38.1) Urinary catheter, n (%) 2109 (26.2) HSCT, n (%) Allogeneic 407 (5.0) Autologous 301 (3.7) Isolation room, n (%) 2352 (29.2)In-hospital mortality, n (%)

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Section: Study Design and Settingmentioning

confidence: 99%

Antimicrobial utilization and antimicrobial resistance in patients with haematological malignancies in Japan: a multi-centre cross-sectional study

Mimura

Fukuda

Akazawa

2020

Ann Clin Microbiol Antimicrob

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“…In the experiments, we utilized 69532 (= D) Diagnosis Procedure Combination [6] (DPC) data that include 114 (= K) kinds of diseases as electronic claims and 274848 (= V) medical procedures. DPC data consist of combinations of some disease names and medical procedures.…”

Section: Resultsmentioning

confidence: 99%

A Most Resource-Consuming Disease Estimation Method from Electronic Claim Data Based on Labeled LDA

Hatakeyama¹,

Ogawa²,

Ikeda³

et al. 2016

IEICE Trans. Inf. & Syst.

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SUMMARYIn this paper, we propose a method to estimate the most resource-consuming disease from electronic claim data based on Labeled Latent Dirichlet Allocation (Labeled LDA). The proposed method models each electronic claim from its medical procedures as a mixture of resourceconsuming diseases. Thus, the most resource-consuming disease can be automatically estimated by applying Labeled LDA to the electronic claim data. Although our method is composed of a simple scheme, this is the first trial for realizing estimation of the most resource-consuming disease.

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“…For purposes of treatment cost reimbursement, attending physicians are obligated to report objective evidence for their diagnosis. 17) An earlier study of these diagnostic and procedural records established validity of the database, with diagnostic specificity exceeding 96%, and sensitivity of 50-80%. Specificity and sensitivity of procedures each exceeded 90%.…”

Section: Data Sourcementioning

confidence: 94%

Changes in Real-world Practice Patterns of Antiepileptic Drugs for Status Epilepticus: A Nationwide Observational Study in Japan

Nakamura

Ohbe

Matsui

et al. 2020

Neurol. Med. Chir.(Tokyo)

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Intravenous (i.v.) phenytoin/fosphenytoin is recommended as the second-line therapy of antiepileptic drugs in patients with status epilepticus (SE). i.v. Levetiracetam is regarded as an effective and safe equivalent with i.v. phenytoin/fosphenytoin. However, i.v. levetiracetam is not covered by public health insurance for SE in most countries. For this study, we performed the real-world practice pattern survey of antiepileptic drugs for status epilepticus using the nationwide inpatient database. We used the Japanese Diagnosis Procedure Combination inpatient database in Japan and identified all cases of emergency admission attributable to status epilepticus from March 2011 through March 2018. We described the patient characteristics and practice pattern of antiepileptic drugs. The analysis conducted for this study examined 31,472 cases. As the second-line therapy, the use of i.v. levetiracetam increased rapidly from 2016; 35% of cases received i.v. levetiracetam in 2017. By contrast, the use of i.v. phenytoin/fosphenytoin decreased from 2016. In-hospital mortality decreased year-by-year. No year-by-year change was observed for deaths within 24 h, length of hospital stay, drug-induced hepatitis, or drug-induced eruption. Although the use of levetiracetam for treatment of SE is not compensated by public health insurance in Japan, i.v. levetiracetam use is increasing dramatically as the second-line SE therapy. We propose that health insurance coverage be extended to include i.v. levetiracetam treatment for SE.

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Development of Casemix Based Evaluation System in Japan

Cited by 44 publications

References 0 publications

Antimicrobial utilization and antimicrobial resistance in patients with haematological malignancies in Japan: a multi-centre cross-sectional study

Antimicrobial utilization and antimicrobial resistance in patients with haematological malignancies in Japan: a multi-centre cross-sectional study

A Most Resource-Consuming Disease Estimation Method from Electronic Claim Data Based on Labeled LDA

Changes in Real-world Practice Patterns of Antiepileptic Drugs for Status Epilepticus: A Nationwide Observational Study in Japan

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