Effective strategy for improving health care outcomes: Multidisciplinary care in cerebral infarction patients

Han, Kyu Tae; Park, Sohee; Kim, Sun Jung; Kim, Woorim; Hahm, Myung Ii; Jang, Sung In; Lee, Sang Kyu

doi:10.1016/j.healthpol.2015.06.005

Cited by 9 publications

(7 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, teaching status, ownership status, and type of medical institution were included to reflect the differences by hospital structural characteristics [ 25 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

Readmission rates of South Korean psychiatric inpatients by inpatient volumes per psychiatrist

et al. 2016

Self Cite

View full text Add to dashboard Cite

BackgroundReadmission rates of psychiatric inpatients are higher in South Korea than other Organization for Economic Co-operation and Development (OECD) countries. In addition, the solution for readmission control is deficient based on the characteristics of the South Korean National Health Insurance (NHI) system. Therefore, it is necessary to identify ways to reduce psychiatric inpatient readmissions. This study investigated the relationship between inpatient volume per psychiatrist and the readmission rate of psychiatric inpatients in South Korea.MethodWe used NHI claim data (N = 37,796) from 53 hospitals to analyze readmission within 30 days for five diagnosis (organic mental disorders, mental and behavioral disorders due to psychoactive substance use, schizophrenia, mood disorders, neurotic disorders, and stress-related and somatoform disorders) between 2010 and 2013. We performed χ2 and analysis of variance tests to investigate associations between patient and hospital-level variables and readmission within 30 days. Finally, generalized estimating equation (GEE) models were analyzed to examine possible associations with readmission.ResultsReadmissions within 30 days accounted for 1,598 (4.5 %) claims. Multilevel analysis demonstrated that inpatient volume per psychiatrist were inversely related with readmission within 30 days (low odds ratio [OR]: 0.38, 95 % confidence interval [CI]: 0.28–0.51; mid-low OR: 0.48, 95 % CI: 0.36–0.63; mid-high OR: 0.55, 95 % CI: 0.44–0.69; Q4 = ref). The subgroup analysis by diagnosis revealed that both “schizophrenia, schizotypal, and delusional disorders” and “mood disorders” had inverse relationships with readmission risk for all volume groups.ConclusionsWe observed an inverse association between inpatient volume per psychiatrist and the 30-day readmission rate of psychiatric inpatients, suggesting that it could be a useful quality indicator in mental health care.

show abstract

“…In addition, teaching status, ownership status, and type of medical institution were included to reflect the differences by hospital structural characteristics [ 25 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

Readmission rates of South Korean psychiatric inpatients by inpatient volumes per psychiatrist

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…[ 7 – 9 ] Clinically, a variety of therapies have been applied to treat the disease, [ 10 , 11 ] but few are effective. [ 12 , 13 ]…”

Section: Introductionmentioning

confidence: 99%

RBPJ polymorphisms associated with cerebral infarction diseases in Chinese Han population

Zhang

Zhou

Liu³

et al. 2018

Medicine

View full text Add to dashboard Cite

Trial design:Cerebral small vessel diseases (CSVDs) are a group of brain pathological processes involving cerebral small arteries, brain venules, and capillaries. The recombination signal-binding protein Jκ (RBPJ) is implicated in the pathogenesis of these diseases but its actual roles need confirmation. The aim of this work was to evaluate variations in RBPJ gene for their possible associations with the disease.Methods:The RBPJ gene was sequenced for 400 patients with cerebral infarction disease and 600 normal controls. The statistical analyses and Hardy–Weinberg equilibrium tests of the patients and control populations were conducted using the SPSS software (version 19.0) and Plink (version 1.9), Haploview software, and online software SNPSpD.Results:We characterized variants rs2871198, rs1397731, rs3822223, rs2077777, rs2270226, and rs2788861 within or near the RBPJ gene. The genetic heterozygosity of rs2871198, rs1397731, rs3822223, rs2077777, and rs2270226 was very high. Statistical analysis showed that the variants rs2270226 and rs2077777 in the gene were associated with the risk of cerebral infarction diseases in the Chinese Han population.Conclusions:rs2270226 and rs2077777 in the RBPJ gene were associated with the risk of cerebral infarction diseases in the Chinese Han population.

show abstract

“…In this view, regulators and hospital managers pointed out that current evidence about the existence of this relationship is not enough robust as studies on hospital performance based on administrative data [7–9]–even if limited to patient-related covariates. Regulators and hospital managers need more conclusive evidence about which managerial practices affect the quality of care to implement improvement strategies [10]. Third, 30-day mortality and 30-day unplanned readmission are competing outcomes [11].…”

Section: Introductionmentioning

confidence: 99%

Multi-level models for heart failure patients’ 30-day mortality and readmission rates: the relation between patient and hospital factors in administrative data

Roshanghalb

Mazzali

Lettieri

2019

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundThis study aims at gathering evidence about the relation between 30-day mortality and 30-day unplanned readmission and patient and hospital factors. By definition, we refer to 30-day mortality and 30-day unplanned readmission as the number of deaths and non-programmed hospitalizations for any cause within 30 days after the incident heart failure (HF). In particular, the focus is on the role played by hospital-level factors.MethodsA multi-level logistic model that combines patient- and hospital-level covariates has been developed to better disentangle the role played by the two groups of covariates. Later on, hospital outliers in term of better-than-expected/worst-than-expected performers have been identified by comparing expected cases vs. observed cases. Hospitals performance in terms of 30-day mortality and 30-day unplanned readmission rates have been visualized through the creation of funnel plots. Covariates have been selected coherently to past literature. Data comes from the hospital discharge forms for Heart Failure patients in the Lombardy Region (Northern Italy). Considering incident cases for HF in the timespan 2010–2012, 78,907 records for adult patients from 117 hospitals have been collected after quality checks.ResultsOur results show that 30-day mortality and 30-day unplanned readmissions are explained by hospital-level covariates, paving the way for the design and implementation of evidence-based improvement strategies. While the percentage of surgical DRG (OR = 1.001; CI (1.000–1.002)) and the hospital type of structure (Research hospitals vs. non-research public hospitals (OR = 0.62; CI (0.48–0.80)) and Non-research private hospitals vs. non-research hospitals OR = 0.75; CI (0.63–0.90)) are significant for mortality, the mean length of stay (OR = 0.96; CI (0.95–0.98)) is significant for unplanned readmission, showing that mortality and readmission rates might be improved through different strategies.ConclusionOur results confirm that hospital-level covariates do affect quality of care, and that 30-day mortality and 30-day unplanned readmission are affected by different managerial choices. This confirms that hospitals should be accountable for their “added value” to quality of care.

show abstract

Effective strategy for improving health care outcomes: Multidisciplinary care in cerebral infarction patients

Cited by 9 publications

References 28 publications

Readmission rates of South Korean psychiatric inpatients by inpatient volumes per psychiatrist

Readmission rates of South Korean psychiatric inpatients by inpatient volumes per psychiatrist

RBPJ polymorphisms associated with cerebral infarction diseases in Chinese Han population

Multi-level models for heart failure patients’ 30-day mortality and readmission rates: the relation between patient and hospital factors in administrative data

Contact Info

Product

Resources

About