Efficiency of inpatient orthopedic surgery in Japan: a medical claims database analysis

2017 ◽  
Vol 30 (6) ◽  
pp. 506-515 ◽  
Author(s):  
Yoshinori Nakata ◽  
Tatsuya Yoshimura ◽  
Yuichi Watanabe ◽  
Hiroshi Otake ◽  
Giichiro Oiso ◽  
...  
Keyword(s):  
Orthopedic Surgery ◽  
Large Scale ◽  
Public Hospitals ◽  
University Hospitals ◽  
Content Type ◽  
Healthcare Facilities ◽  
Claims Database ◽  
Medical Claims ◽  
Decision Making Unit ◽  
Medical Claims Database

Purpose The purpose of this paper is to determine the characteristics of healthcare facilities that produce the most efficient inpatient orthopedic surgery using a large-scale medical claims database in Japan. Design/methodology/approach Reimbursement claims data were obtained from April 1 through September 30, 2014. Input-oriented Banker-Charnes-Cooper model of data envelopment analysis (DEA) was employed. The decision-making unit was defined as a healthcare facility where orthopedic surgery was performed. Inputs were defined as the length of stay, the number of beds, and the total costs of expensive surgical devices. Output was defined as total surgical fees for each surgery. Efficiency scores of healthcare facilities were compared among different categories of healthcare facilities. Findings The efficiency scores of healthcare facilities with a diagnosis-procedure combination (DPC) reimbursement were significantly lower than those without DPC (p=0.0000). All the efficiency scores of clinics with beds were 1. Their efficiency scores were significantly higher than those of university hospitals, public hospitals, and other hospitals (p=0.0000). Originality/value This is the first research that applied DEA for orthopedic surgery in Japan. The healthcare facilities with DPC reimbursement were less efficient than those without DPC. The clinics with beds were the most efficient among all types of management bodies of healthcare facilities.

scholarly journals Drug Repositioning Research Utilizing a Large-scale Medical Claims Database to Improve Survival Rates after Cardiopulmonary Arrest

2017 ◽  
Vol 137 (12) ◽  
pp. 1439-1442
Author(s):  
Yoshito Zamami ◽  
Takahiro Niimura ◽  
Kenshi Takechi ◽  
Masaki Imanishi ◽  
Toshihiro Koyama ◽  
...  
Keyword(s):  
Large Scale ◽  
Drug Repositioning ◽  
Cardiopulmonary Arrest ◽  
Survival Rates ◽  
Claims Database ◽  
Medical Claims ◽  
Medical Claims Database

scholarly journals Efect of nicorandil on survival of patients with cardiac arrest using large-scale medical claims database

2018 ◽  
Vol WCP2018 (0) ◽  
pp. PO4-1-59
Author(s):  
Takahiro Niimura ◽  
Yoshito Zamami ◽  
Yuki Izawa-Ishizawa ◽  
Kenshi Takechi ◽  
Masaki Imanishi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Large Scale ◽  
Claims Database ◽  
Medical Claims ◽  
Medical Claims Database

Effect of parenteral energy or amino acid doses on in-hospital mortality, among patients with aspiration pneumonia: a cohort medical claims database study

2021 ◽  
Author(s):  
Keisuke Maeda ◽  
Kenta Murotani ◽  
Satoru Kamoshita ◽  
Yuri Horikoshi ◽  
Akiyoshi Kuroda
Keyword(s):  
Amino Acid ◽  
Hospital Mortality ◽  
Aspiration Pneumonia ◽  
Low Dose ◽  
Oral Intake ◽  
Reference Level ◽  
Claims Database ◽  
Medical Claims ◽  
Dose Levels ◽  
Medical Claims Database

Abstract Background This study examined the association between parenteral energy/amino acid doses and in-hospital mortality among inpatients on long-term nil per os (NPO) status, using a medical claims database in Japan. Methods Hospitalized patients with aspiration pneumonia, aged ≥65 years and on >7-days NPO status, were identified in a medical claims database between January 2013 and December 2018. Using multivariate logistic regression and regression analyses, we examined the association between mean parenteral energy/amino acid doses and in-hospital mortality, and secondarily the association between prognosis (in-hospital mortality, inability to receive full oral intake, re-admission, hospital stay length) among four groups classified by mean amino acid dose (No dose: 0 g/kg/day; Very low dose: >0, ≤0.3 g/kg/day; Low dose: >0.3, ≤0.6 g/kg/day; Moderate dose: >0.6 g/kg/day). Results The analysis population included 20,457 inpatients (≥80 years: 78.3%). In total, 5,920 mortalities were recorded. Increased amino acid doses were significantly associated with reduced in-hospital mortality (p <0.001). With a No dose reference level, the odds ratios (95% confidence interval) of in-hospital mortality adjusted for potential confounders, were 0.78 (0.72–0.85), 0.74 (0.67–0.82), and 0.69 (0.59–0.81) for Very low, Low, and Moderate amino acid doses, respectively. Additionally, patients prescribed amino acid dose levels >0.6 g/kg/day had shorter hospitalization periods than those prescribed none. Conclusions Increased amino acid doses were associated with reduced in-hospital mortality. Sufficient amino acid administration is recommended for patients with aspiration pneumonia requiring NPO status.

Association between outpatient orthopedic surgery costs and healthcare facility characteristics

2018 ◽  
Vol 31 (3) ◽  
pp. 265-272 ◽  
Author(s):  
Yuichi Watanabe ◽  
Yoshinori Nakata
Keyword(s):  
Regression Analysis ◽  
Orthopedic Surgery ◽  
Multivariate Regression ◽  
Healthcare Facility ◽  
Ordinary Least Squares ◽  
Patient Specific ◽  
Content Type ◽  
Healthcare Facilities ◽  
Total Cost ◽  
Surgical Costs

Purpose The purpose of this paper is to examine the association between outpatient orthopedic surgery costs and Japan’s healthcare facilities using a large-scale Japanese medical claims database. Design/methodology/approach The authors obtained reimbursement claims data for 8,588 patients who underwent orthopedic surgery between April 1 and September 30, 2014 at 3,347 Japanese healthcare facilities. Regression analysis, using ordinary least squares, examined the association between outpatient orthopedic surgery costs and healthcare facility characteristics. By using surgical fees as proxy for the surgical costs, the authors defined three dependent variables: surgical cost for each outpatient orthopedic surgery; pre- and post-operative cost one month before and after a surgical operation; and total cost for each patient. The authors also defined five independent variables, which capture healthcare facility characteristics and patient-specific factors: bed count; whether healthcare facilities are reimbursed in a diagnosis procedure combination system; patient’s age; sex; and anatomical surgical sites. Findings The authors analyzed 6,456 outpatient orthopedic surgical cases performed at 3,085 healthcare facilities. There were significant differences in the surgical costs for outpatient orthopedic surgery among different healthcare facilities by total beds (p=0.000). Multivariate regression analysis shows that surgical costs for outpatient orthopedic surgery are positively and significantly associated with healthcare facilities classified by total beds after adjusting for patient-specific characteristics (p<0.05). Originality/value This is the first research to examine the association between costs for outpatient orthopedic surgery and healthcare facility characteristics in Japan. This study via the multivariate regression method showed that outpatient orthopedic surgery is likely to cost higher as healthcare facility size increased. The average incremental costs for each outpatient orthopedic surgery per 100 beds were calculated at $48.5 for surgery, $40.7 for pre- and post-operative care, and $89.2 total cost.

Sign in / Sign up

Export Citation Format

Share Document