Impact of hospital volume on clinical outcomes of endoscopic biliary drainage for acute cholangitis based on the Japanese administrative database associated with the diagnosis procedure combination system

Murata, Atsuhiko; Matsuda, Shinya; Kuwabara, Kazuaki; Fujino, Yoshihisa; Kubo, Toshikazu; Fujimori, Kenji; Horiguchi, Hiromasa

doi:10.1007/s00535-010-0257-x

Cited by 24 publications

(46 citation statements)

References 32 publications

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“…These hospitals are situated throughout Japan and play leading roles in providing acute care medicine, advancing medical research, and educating students and medical residents (Murata et al 2010(Murata et al , 2012. The principal diagnosis of acute abdominal pain was recorded using the ICD-10th code.…”

Section: Study Settingmentioning

confidence: 99%

“…The CCI was expressed as the score of comorbid conditions and initially evaluated as a continuous variable. The categorical variables of CCI defining four categories for the severity of the comorbid conditions were created to simplify the presentation of the results: 0 and 1, mild; 2, moderate; and 3 or more, severe (Murata et al 2010(Murata et al , 2012. The presence of surgical treatments for patients was determined by the data of the operation code.…”

Section: Study Variablesmentioning

confidence: 99%

“…The DPC system was introduced into 82 academic hospitals in 2003 (Murata et al 2010(Murata et al , 2012. Insurance reimbursements using the DPC system are widespread in Japan, and the administrative database of the DPC system has increased the representation of acute care hospitals over time.…”

Section: Methodsmentioning

confidence: 99%

“…Insurance reimbursements using the DPC system are widespread in Japan, and the administrative database of the DPC system has increased the representation of acute care hospitals over time. As of 2007, data from approximately 450,000 inpatients have been compiled, representing approximately 90% of all acute care inpatient hospitalizations in Japan (Murata et al 2010(Murata et al , 2012. The DPC administrative database includes each patient's discharge summary and claim information, including principal diagnosis (disease which triggered admission or main disease on discharge), comorbidities at the time of admission, and complications during hospitalization .…”

Section: Methodsmentioning

confidence: 99%

“…These codes are determined by the Ministry of Health, Labour and Welfare of Japan. The DPC database also includes the quantity and date of all care delivered on a daily basis during hospitalization (Murata et al 2010(Murata et al , 2012.…”

Section: Methodsmentioning

confidence: 99%

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Age-Related Differences in Outcomes and Etiologies of Acute Abdominal Pain Based on a National Administrative Database

Murata

Okamoto

Mayumi

et al. 2014

Tohoku J. Exp. Med.

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Acute abdominal pain is one of the most frequent causes of admission to emergency departments. However, there is a shortage of detail information showing the difference of outcomes or etiology of acute abdominal pain according to age. We therefore conducted an epidemiological analysis to reveal the difference between age on outcomes and etiology of acute abdominal pain using an administrative database associated with the Diagnosis Procedure Combination (DPC) system. We obtained discharge data relating to 12,209 patients with acute abdominal pain from 931 DPC participation hospitals between 2009 and 2011 in Japan. We compared length of hospital stay (LOS), in-hospital mortality, and etiology of acute abdominal pain between age categories. Patients were divided into five age groups as follows: < 20 (n = 1,106), 20-39 (n = 3,353), 40-59 (n = 2,925), 60-79 (n = 3,144), and ≥ 80 years (n = 1,681). Longer LOS and higher in-hospital mortality were observed in patients aged ≥ 80 years (p < 0.001). Regarding etiologies of acute abdominal pain, intestinal infection or acute appendicitis were more frequent in patients aged < 20 or 20-39 years, while ileus or cholelithiasis were more frequent in patients aged 60-79 or ≥ 80 years in both male and female patients (p < 0.001). This study demonstrated the significant differences between age with regard to the patient outcomes and etiology of acute abdominal pain. The current findings highlight the importance of improving the quality of medical care for patients with acute abdominal pain.

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Section: Study Settingmentioning

confidence: 99%

Section: Study Variablesmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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