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Developing a prediction model of readmission and strategy for preventing readmission by using big medical claim data

Research Project

Project/Area Number 20H03924
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Review Section Basic Section 58010:Medical management and medical sociology-related
Research InstitutionTokyo Metropolitan Geriatric Hospital and Institute of Gerontology

Principal Investigator

光武 誠吾  地方独立行政法人東京都健康長寿医療センター(東京都健康長寿医療センター研究所), 東京都健康長寿医療センター研究所, 研究員 (10520992)

Co-Investigator(Kenkyū-buntansha) 土屋 瑠見子  一般財団法人医療経済研究・社会保険福祉協会(医療経済研究機構(研究部)), 研究部, 主任研究員 (20726525)
石崎 達郎  地方独立行政法人東京都健康長寿医療センター(東京都健康長寿医療センター研究所), 東京都健康長寿医療センター研究所, 研究部長 (30246045)
Project Period (FY) 2020-04-01 – 2024-03-31
Project Status Granted (Fiscal Year 2023)
Budget Amount *help
¥17,680,000 (Direct Cost: ¥13,600,000、Indirect Cost: ¥4,080,000)
Fiscal Year 2023: ¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000)
Fiscal Year 2022: ¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000)
Fiscal Year 2021: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Fiscal Year 2020: ¥7,280,000 (Direct Cost: ¥5,600,000、Indirect Cost: ¥1,680,000)
Keywords再入院 / ビッグデータ / 移行期ケア / リハビリテーション / 高齢者 / 入院関連合併症 / 退院支援 / 再入院予防 / 老年医学 / ヘルスサービスリサーチ
Outline of Research at the Start

欧米では医療の質の指標として退院直後の再入院が注目されており、再入院予防策は公衆衛生上の重要課題となっている。本研究では、医療・介護ビッグデータを用いて、高齢入院患者の認知機能・生活機能・フレイルを含めた退院直後の再入院発生予測モデルを検討するとともに、退院前後のケアに関わる医療・介護サービスが再入院予防に与える効果を明らかにする。最終的に、わが国の実情に合わせた退院直後の再入院予防策に対する提言を行う。

Outline of Annual Research Achievements

東京都健康長寿医療センターのDPC・DASCデータ連結データベースの構築、更新作業を行うとともに、連結データベースを活用し、全疾患による再入院と予防可能な再入院の予測モデルを比較検討した。入院時のフレイルリスク、併存疾患、ADL等から構築される予測モデルは、『全疾患による再入院(C-statistic: 0.73, 95% confidence interval:0.71–0.75)』よりも『予防可能な再入院(C-statistic:0.79, 95% confidence interval: 0.77–0.82)』の方が高い精度をもつことが分かった。この研究成果は、アメリカ老年学会が刊行する国際科学雑誌「Innovation in aging」に掲載された。

北海道後期高齢者における医療レセプトデータベースを活用し、診療保険下で入院中の心身機能の低下予防に着目した医療サービス(ADL維持向上加算)が『予防可能な再入院』に及ぼす効果について検証中である。

Current Status of Research Progress
Current Status of Research Progress

3: Progress in research has been slightly delayed.

Reason

診療保険下で入院中の心身機能の低下予防に着目した医療サービスが、『予防可能な再入院』に及ぼす効果検証に活用する医療レセプトデータにエラーが見つかり、データの再抽出作業を行ったことで計画よりもやや遅れている。

Strategy for Future Research Activity

北海道後期高齢者における医療レセプトデータベースを活用し、診療保険下で入院中の心身機能の低下予防に着目した医療サービス(ADL維持向上加算)が『予防可能な再入院』に及ぼす効果について検討する。また、文献レビューも行い、我が国における再入院予防策に関する方策をまとめていく。

Report

(3 results)
  • 2022 Annual Research Report
  • 2021 Annual Research Report
  • 2020 Annual Research Report
  • Research Products

    (9 results)

All 2023 2022 2021

All Journal Article (6 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 6 results,  Open Access: 4 results) Presentation (3 results) (of which Int'l Joint Research: 3 results)

  • [Journal Article] All-Cause Readmission or Potentially Avoidable Readmission: Which Is More Predictable Using Frailty, Comorbidities, and ADL?2023

    • Author(s)
      Mitsutake Seigo、Ishizaki Tatsuro、Yano Shohei、Tsuchiya-Ito Rumiko、Uda Kazuaki、Toba Kenji、Ito Hideki
    • Journal Title

      Innovation in Aging

      Volume: 7 Issue: 5

    • DOI

      10.1093/geroni/igad043

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Association of functional and cognitive impairment severity with discharge to long-term care facilities in older patients admitted to a general acute care hospital from home2023

    • Author(s)
      Mitsutake Seigo、Yano Shohei、Ishizaki Tatsuro、Furuta Ko、Hatakeyama Akira、Sugiyama Mika、Awata Shuichi、Ito Hideki、Toba Kenji
    • Journal Title

      Archives of Gerontology and Geriatrics

      Volume: 115 Pages: 105111-105111

    • DOI

      10.1016/j.archger.2023.105111

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Effects of Early Postdischarge Rehabilitation Services on Care Needs?Level Deterioration in Older Adults With Functional Impairment: A Propensity Score?Matched Study2022

    • Author(s)
      Mitsutake Seigo、Ishizaki Tatsuro、Tsuchiya-Ito Rumiko、Uda Kazuaki、Jinnouchi Hiroshige、Ueshima Hiroaki、Matsuda Tomoyuki、Yoshie Satoru、Iijima Katsuya、Tamiya Nanako
    • Journal Title

      Archives of Physical Medicine and Rehabilitation

      Volume: 103 Issue: 9 Pages: 1715-1722.e1

    • DOI

      10.1016/j.apmr.2021.12.024

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Association of cognitive impairment severity with potentially avoidable readmissions: A retrospective cohort study of 8897 older patients2021

    • Author(s)
      Mitsutake Seigo, Ishizaki Tatsuro, Tsuchiya‐Ito Rumiko, Furuta Ko, Hatakeyama Akira, Sugiyama Mika, Toba Kenji, Ito Hideki
    • Journal Title

      Alzheimers Dement

      Volume: 13 Issue: 1

    • DOI

      10.1002/dad2.12147

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Agreement on dementia severity levels between the 8‐item and 21‐item Dementia Assessment Sheet for Community‐based Integrated Care System2021

    • Author(s)
      Mitsutake Seigo, Ishizaki Tatsuro, Furuta Ko, Hatakeyama Akira, Sugiyama Mika, Awata Shuichi, Toba Kenji, Ito Hideki
    • Journal Title

      Geriatr Gerontol Int

      Volume: 21 Issue: 8 Pages: 748-749

    • DOI

      10.1111/ggi.14205

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Characteristics associated with hospitalization within30 days of geriatric intermediate care facility admission2021

    • Author(s)
      Mitsutake Seigo, Ishizaki Tatsuro, Yano Shohei, Tsuchiya‐Ito Rumiko, Jin Xueying, Watanabe Taeko, Uda Kazuaki, Livingstone Ian, Tamiya Nanako
    • Journal Title

      Geriatr Gerontol Int

      Volume: 21 Issue: 11 Pages: 1010-1017

    • DOI

      10.1111/ggi.14278

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Presentation] Association of the Diagnosis Procedure Combination Data Version of Hospital-Associated Complications of Older People with hospital length of stay and discharge to a facility or hospital2023

    • Author(s)
      Mitsutake S, Ishizaki T, Yano S, Ito K, Furuta K, Hatakeyama A, Shimazaki Y, Awata S, Ito H, Toba K
    • Organizer
      IAGG Asia/Oceania Regional Congress 2023
    • Related Report
      2022 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Dementia severity associated with discharge to a long-term care facility in older patients admitted to a general acute care hospital from home2023

    • Author(s)
      Yano S, Mitsutake S, Ishizaki T, Furuta K, Hatakeyama A, Sugiyama M, Awata S, Ito H, Toba K
    • Organizer
      IAGG Asia/Oceania Regional Congress 2023
    • Related Report
      2022 Annual Research Report
    • Int'l Joint Research
  • [Presentation] All-cause readmission or potentially avoidable readmission: Which is more predictable using frailty, comorbidities, and activities of daily living?2022

    • Author(s)
      Mitsutake S, Ishizaki T, Yano S, Tsuchiya-Ito R, Uda K.
    • Organizer
      22nd World Congress of Gerontology and Geriatrics IAGG 2022
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research

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Published: 2020-04-28   Modified: 2024-12-25  

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