Length of hospital stay in Japan 1971–2008: Hospital ownership and cost-containment policies

Kato, Naoko; Kondo, Masahide; Okubo, Ichiro; Hasegawa, Toshihiko

doi:10.1016/j.healthpol.2014.01.002

Cited by 15 publications

(15 citation statements)

References 16 publications

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“…In the context of Japan's super‐aging society, the provision of medical services has been undergoing a shift from hospital‐centered to community‐oriented service in combination with nursing care and social care . The average length of stay in acute hospitals has become shorter, and post‐acute care has become more important for people with greater medical needs . Some types of long‐term care (LTC) facilities play a partial role in providing post‐acute care for older adults who cannot be discharged home.…”

Section: Introductionmentioning

confidence: 99%

“…1 The average length of stay in acute hospitals has become shorter, and post-acute care has become more important for people with greater medical needs. 2 Some types of long-term care (LTC) facilities play a partial role in providing post-acute care for older adults who cannot be discharged home. The Geriatric Health Services facility, or Roken, is one major intermediate care facility of this type for older adults.…”

Section: Introductionmentioning

confidence: 99%

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Drug costs in long‐term care facilities under a per diem bundled payment scheme in Japan

Hamada

Kojima

Sakata

et al. 2019

Geriatrics Gerontology Int

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Aim The present study aimed to evaluate drug costs per resident at Japanese intermediate care facilities for older adults (called Roken) in relation to drug utilization after admission to these facilities. The payment, including coverage of drugs, is mainly determined by the resident's long‐term care needs. Methods A nationwide drug utilization survey was carried out. The participants were 1324 residents of 350 Roken (up to five individuals per facility) who were admitted in 2015 and agreed to participate in this study. Drug costs per resident per month at admission and 2 months later were calculated for drugs prescribed for regular use. Associations between characteristics of the residents and drug costs were examined. Results A wide variation in drug costs with a long right tail was observed. Median drug costs were $77 (interquartile range $34–147) at admission, and $46 (interquartile range $19–98) in month 2. There was no apparent association between the level of long‐term care needs and drug costs, adjusting for sex, age and main place of residence before admission. Anti‐dementia drugs accounted for the largest portion of total drug costs at admission (15.4%) and in month 2 (12.4%). The average drug cost per user was also the highest for anti‐dementia drugs ($90.2 per user per month), followed by drugs for Parkinson's disease ($70.3). The proportion of generic drugs across all drug classes examined increased after admission. Conclusions These findings might suggest that implementation of the bundled payment scheme would be effective for the reduction of medication costs in institutional long‐term care. Geriatr Gerontol Int 2019; 19: 667–672.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Drug costs in long‐term care facilities under a per diem bundled payment scheme in Japan

Hamada

Kojima

Sakata

et al. 2019

Geriatrics Gerontology Int

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show abstract

“…FFS model encourages health providers to apply more procedures that may lead to the increase in patients' hospitalization days [4]. Contrary to that, the decline in LOS among Japanese hospitals is considered to be due to cost-containment policies based on DRG-like payment system [7]. Given these competing hypotheses, the different payment systems are likely to affect hospital behavior in raising or lowering the intensity of care provided by LOS.…”

Section: The 2nd International Meeting Of Public Health 2016mentioning

confidence: 99%

Length of Hospital Stay in Different Health Insurance Payment Systems

Purbaningsih¹,

Pujiyanto²,

Sari³

et al. 2018

KLS

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Before the merging of health insurance schemes in 2014, Indonesia has two type of government health insurance programs based on its payment system. Jamkesmas applied diagnosis-related groups-based (DRG) payment system, while Askes and Jamsostek are much alike to fee-for-service (FFS) model. The different payment systems likely affect hospital behavior in delivering health services. One direct measure to address this issue is hospital length of stay (LOS). This paper focuses to examine the effect of Indonesia's health insurance payment systems on hospital LOS using the Indonesia National Socio-Economic Survey (Susenas) 2012 dataset. Count data model is used to address endogeneity issue of health insurance. Our findings suggest that FFS insurance have strong effect to increase LOS, on the contrary, DRG insurance give strong effect to reduce LOS. This finding supports the idea that FFS encourages hospitals to apply more services, while DRG encourages hospitals to keep their costs low to avoid making loss.

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“…In most patient populations, increased LOS is thought to incur higher hospital costs and decreased profitability, although evidence supporting this is scant . LOS is commonly used to quantify hospital performance, and so lowering LOS is often emphasized as it is believed to be correlated with improved cost containment . Whether lowered LOS actually results in hospital savings is unclear .…”

mentioning

confidence: 99%

“…1 LOS is commonly used to quantify hospital performance, and so lowering LOS is often emphasized as it is believed to be correlated with improved cost containment. 2,3 Whether lowered LOS actually results in hospital savings is unclear. 4 A study showed that reducing the LOS by as much as an entire day reduced the total cost of care by only 3%.…”

mentioning

confidence: 99%

Length of stay for patients undergoing invasive electrode monitoring with stereoelectroencephalography and subdural grids correlates positively with increased institutional profitability

et al. 2017

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Length of hospital stay in Japan 1971–2008: Hospital ownership and cost-containment policies

Cited by 15 publications

References 16 publications

Drug costs in long‐term care facilities under a per diem bundled payment scheme in Japan

Drug costs in long‐term care facilities under a per diem bundled payment scheme in Japan

Length of Hospital Stay in Different Health Insurance Payment Systems

Length of stay for patients undergoing invasive electrode monitoring with stereoelectroencephalography and subdural grids correlates positively with increased institutional profitability

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