Multivariate analysis of factors influencing medical costs of acute pancreatitis hospitalizations based on a national administrative database

Murata, Atsuhiko; Matsuda, Shinya; Mayumi, Toshihiko; Okamoto, Kohji; Kuwabara, Kazuaki; Ichimiya, Yukako; Fujino, Yoshihisa; Kubo, Toshikazu; Fujimori, Kenji; Horiguchi, Hiromasa

doi:10.1016/j.dld.2011.08.011

Cited by 39 publications

(74 citation statements)

References 32 publications

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“…Acute cholecystitis is usually treated in acute care hospitals. One of the benefits of the national database was that it enabled evaluation of a large number of acute care hospitals in an unbiased manner, because our investigation involved a nationally representative sample of patients with acute cholecystitis in a community setting (Murata et al 2010(Murata et al , 2012. Therefore, the data from this administrative database closely reflect the clinical circumstances of the procedures and treatments for acute cholecystitis.…”

Section: Discussionmentioning

confidence: 99%

“…To solve these problems, the Ministry of Health, Labour and Welfare and its affiliated research institute have started research on the feasibility of using the Japanese case-mix classification system as a tool for standardized medical profiling and payment (Matsuda 2008). As a result, Japanese case-mix projects based on the DPC system were introduced to 82 academic hospitals (80 university hospitals, the National Cancer Centre, and the National Cardiovascular Centre) in 2003 (Murata et al 2010(Murata et al , 2012. Insurance reimbursement using the DPC system is now very prevalent in Japan, and the administrative database of the DPC system has increased the representation of acute care hospitals.…”

Section: Administrative Database Associated With the Dpc Systemmentioning

confidence: 99%

“…These hospitals are spread throughout Japan and play a leading role in providing acute care medicine, advancing medical research, and educating students and medical residents (Murata et al 2010(Murata et al , 2012.In the present study, acute cholecystitis was defined as code K810 in the ICD-10th. For this analysis, we excluded 10 patients less than 15 years of age because the causes of pediatric acute cholecystitis are quite different from those of adult acute cholecystitis (e.g., serious burns, metabolic diseases or bone marrow transplantation) .…”

Section: Study Settingmentioning

confidence: 99%

“…The administrative database associated with the DPC system includes each patient's discharge summary and claim information, including principal diagnosis, and comorbidities and complications during hospitalization (Murata et al 2010(Murata et al , 2012Ichimiya et al 2011). These data are coded in accordance with the International Classification of Diseases and Injuries (ICD)-10th edition.…”

Section: Administrative Database Associated With the Dpc Systemmentioning

confidence: 99%

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

Section: Administrative Database Associated With the Dpc Systemmentioning

confidence: 99%

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The Care Processes for Acute Cholecystitis According to Clinical Practice Guidelines Based on the Japanese Administrative Database

Murata

Okamoto

Matsuda

et al. 2012

Tohoku J. Exp. Med.

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Acute cholecystitis is one of the most frequently encountered conditions in daily practice in Japan. However, there is a shortage of detailed data about treatments that have been performed according to the clinical practice guidelines (CPGs) for acute cholecystitis. We therefore examined the management of acute cholecystitis for adherence to the appropriate CPGs using the Japanese administrative database associated with the Diagnosis Procedure Combination (DPC) system. We collected data from 6,070 patients with acute cholecystitis, examining for the application of four recommended treatments (administration of antimicrobial drugs and nonsteroidal anti-inflammatory drugs (NSAIDs) and performance of early and laparoscopic cholecystectomy). The patients were classified according to the procedures documented for each case: no gallbladder drainage (n = 4,333), gallbladder drainage without supportive care (ventilation or hemodiafiltration or the use of vasopressor) (n = 1,591) and gallbladder drainage and supportive care (n = 146). Multiple logistic regression models revealed that patients with gallbladder drainage without supportive care and those with gallbladder drainage and supportive care significantly higher received administration of antimicrobial drugs and NSAIDs, while these patients underwent less early or laparoscopic cholecystectomy than did patients without gallbladder drainage, after adjusting for potential confounding effects of the clinical variables. This study demonstrated that there were various differences with regard to the performance of recommended treatments between the levels of procedures required for acute cholecystitis. In addition, this administrative database was a feasible tool for the evaluation of care processes and will provide useful information contributing to improved quality of medical care.

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Section: Discussionmentioning

confidence: 99%

Section: Administrative Database Associated With the Dpc Systemmentioning

confidence: 99%

Section: Study Settingmentioning

confidence: 99%

Section: Administrative Database Associated With the Dpc Systemmentioning

confidence: 99%

Section: Administrative Database Associated With the Dpc Systemmentioning

confidence: 99%

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