Endoscopic submucosal dissection for gastric cancer in elderly Japanese patients: An observational study of financial costs of treatment based on a national administrative database

Abstract

LOS and medical costs during hospitalization were significantly higher in elderly patients undergoing ESD for GC than in non-elderly patients, although there was no difference in the incidence of ESD-related complications.

Recent Change in Treatment of Disseminated Intravascular Coagulation in Japan

“…[11][12][13] To address these issues, the Ministry of Health, Labour, and Welfare and its affiliated research institute have begun investigating whether the Japanese case-mix classification system, namely, the DPC, can be used to standardize medical profiling and payment. [11][12][13] Japanese case-mix projects based on the DPC system were introduced to 82 academic hospitals (the National Cancer Center, the National Cardiovascular Center, and 80 university hospitals) in 2003. [11][12][13][14][15] Reimbursement from health insurance using the DPC system is common practice in Japan.…”

“…[11][12][13] Japanese case-mix projects based on the DPC system were introduced to 82 academic hospitals (the National Cancer Center, the National Cardiovascular Center, and 80 university hospitals) in 2003. [11][12][13][14][15] Reimbursement from health insurance using the DPC system is common practice in Japan. According to the administrative database of the DPC system, the number of acute-care hospitals has increased.…”

“…Enormous amounts of inpatient data are collected annually, covering approximately 90% of the total acute-care inpatient hospitalizations. [11][12][13][14][15] This system also collects important data during hospitalization in addition to the characteristics of the unique reimbursement system. Each patient's financial data, claim information, and discharge summary (including the principal diagnosis, complications, and comorbidities during hospitalization) are thoroughly recorded in the administrative database of the DPC system.…”

“…These hospitals are dispersed throughout Japan and play leading roles in providing acute-care medicine, advancing medical research, and educating students and medical residents. [11][12][13][14][15] For the present analysis, 3 study periods were established according to the following fiscal years: 2010 (n ¼ 3308), 2011 (n ¼ 5403), and 2012 (n ¼ 5613).…”

“…The DPC-participating hospitals send all the anonymized data to the DPC research group, which in turn sends it to the server in our department. [11][12][13][14][15] The use of DPC data was permitted by all institutions and hospitals that provided detailed data. The research protocol of the study was approved by the ethics committee of medical care and research of the University of Occupational and Environmental Health, Kitakyushu, Japan.…”