Development of methods for risk adjustment and quality evaluation of health care by administrative data

• Project/Area Number: 21590556
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Medical sociology
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: FUSHIMI Kiyohide 東京医科歯科大学, 医学部・附属病院, 教授 (50270913)
• Project Period (FY): 2009 – 2011
• Project Status: Completed (Fiscal Year 2011)
• Budget Amount: ¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000); Fiscal Year 2011: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2010: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2009: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
• Keywords: 医療の質 / 診断群分類 / 医療データ / 医療サービス研究 / 診療プロセス分析 / 患者リスク調整

Research Abstract

DPC data is administrative data of acute care hospitals in Japan potentially useful for the analysis of health care quality and the assessment of hospital functions. The purpose of this study was to develop methodology for health care quality analysis by DPC administrative data. We have shown successful outcome assessment including hospital death rate after acute coronary interventions and the length of hospital stay after hip fracture surgery by case-mix adjustment with DPC process data. We have shown that DPC data is highly valuable for health care quality assessment and clinical epidemiology. The construction and maintenance of comprehensive and representative DPC data base for clinical research use is mandatory for high quality clinical investigations and evidence-based health policy in Japan.

Research Products

• [Journal Article] Relationship between hospital volume and outcomes following primarypercutaneous coronary intervention in patients with acute myocardial infarction (2011)
  • Author(s): Kuwabara, H., Fushimi, K., Matsuda, S.
  • Journal Title: Circ J Volume: 75(5) Pages: 1107-1112
  • Peer Reviewed
• [Journal Article] Factors associated with a protracted hospital stay after hip fracture surgery in Japan (2011)
  • Author(s): Takahashi, C., Fushimi, K., Matsuda, S.
  • Journal Title: Geriatrics & Gerontology International Volume: 11(4) Pages: 474-481
  • NAID: 10030468539
  • Peer Reviewed
• [Journal Article] Factors associated with adherence to prophylactic antibiotic therapy for elective general surgeries in Japan (2011)
  • Author(s): Imai-Kamata, S., Fushimi, K.
  • Journal Title: International Journal for Quality in Health Care Volume: 23(2) Pages: 167-172
  • Peer Reviewed
• [Journal Article] Community-based evaluation of laparoscopic versus open simple closure of perforated peptic ulcers (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K.B., Horiguchi, H., Fujimori, K.
  • Journal Title: World J Surg Volume: 35(11) Pages: 2485-2492
  • Peer Reviewed
• [Journal Article] Early crystalloid fluid volume management in acute pancreatitis : association with mortality and organ failure (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K.B., Horiguchi, H., Fujimori, K.
  • Journal Title: Pancreatology Volume: 11(3) Issue: 3 Pages: 351-361
  • DOI: 10.1159/000328965
  • Peer Reviewed
• [Journal Article] Relationships of age, cholecystectomy approach and timing with the surgical and functional outcomes of elderly patients with cholecystitis (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K.B., Horiguchi, H., Fujimori, K.
  • Journal Title: Int J Surg Volume: 9(5) Issue: 5 Pages: 392-399
  • DOI: 10.1016/j.ijsu.2011.03.026
  • Peer Reviewed
• [Journal Article] Relationship between hospital volume and outcomes following primary percutaneous coronary intervention in patients with acute myocardial infarction (2011)
  • Author(s): Kuwabara, H., Fushimi, K., Matsuda, S.
  • Journal Title: Circ J Volume: 75(5) Pages: 1107-1112
  • NAID: 10028147400
  • Peer Reviewed
• [Journal Article] Reappraising the Surgical Approach on the Perforated Gastroduodenal Ulcer : Should Gastric Resection Be Abandoned? (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K.B., Horiguchi, H., Fujimori, K.
  • Journal Title: Journal of Clinical Medicine Research Volume: 3(5) Pages: 213-222
  • DOI: 10.4021/jocmr608w
  • Peer Reviewed
• [Journal Article] Quantification of Resource Utilization to Obtain Functional Recovery in Strokes (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K.B., Horiguchi, H., Fujimori, K.
  • Journal Title: Journal of Neurology Research Volume: 1(3) Pages: 96-104
  • DOI: 10.4021/jnr42w
  • Peer Reviewed
• [Journal Article] Re-Justification for Reducing the Length of Hospital Stay Based on Community-Based Appraisal of Functional Recovery of Cerebrovascular Disease Patient (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K.B., Horiguchi, H., Fujimori, K.
  • Journal Title: Journal of Neurology Research Volume: 1(2) Pages: 59-68
  • DOI: 10.4021/jnr18e
  • Peer Reviewed
• [Journal Article] Community-Based Appraisal of the Effects of Parenteral Nutrition Versus Enteral Nutrition on the Quality of Care for Patients With Acute Pancreatitis (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K.B., Horiguchi, H., Fujimori, K.
  • Journal Title: Gastroenterology Research Volume: 4(1) Pages: 1-8
  • DOI: 10.4021/gr289w
  • Peer Reviewed
• [Journal Article] Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries (2011)
  • Author(s): Quan, H., Li, B., Couris, CM., Fushimi, K., Graham, P., Hider, P., Januel, JM., Sundararajan, V.
  • Journal Title: Am J Epidemiol Volume: 173(6) Pages: 676-682
  • Peer Reviewed
• [Journal Article] Quantitative evaluation of age disparities in the quality of geriatric acute medical care in Japan (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K.B., Horiguchi, H., Fujimori, K.
  • Journal Title: International Journal of Gerontology Volume: 5(3) Issue: 3 Pages: 139-145
  • DOI: 10.1016/j.ijge.2011.09.033
  • Peer Reviewed
• [Journal Article] Community-Based Appraisal of Laparoscopic Abdominal Surgery in Japan (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K.B., Horiguchi, H., Fujimori, K.
  • Journal Title: Journal of Surgical Research Volume: 165(1)
  • Peer Reviewed
• [Journal Article] Quantitative assessment of the advantages of laparoscopic gastrectomy and the impact of volume-related hospital characteristics on resource use and outcomes of gastrectomy patients in Japan (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K..B., Horiguchi, H., Fujimori, K., Yasunaga, H., Miyata, H.
  • Journal Title: Annals of Surgery Volume: 253(1) Pages: 64-70
  • Peer Reviewed
• [Journal Article] Reconsidering the value of rehabilitation for patients with cerebrovascular disease in Japanese acute health care hospitals (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K.B., Horiguchi, H., Fujimori, K.
  • Journal Title: Value in Health Volume: 14(1) Pages: 166-176
  • Peer Reviewed
• [Journal Article] Contribution of case-mix classification to profiling hospital characteristics and productivity (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K.B., Horiguchi, H., Hayashida, K., Fujimori, K.
  • Journal Title: International Journal of Health Planning and Management Volume: 26(3)
  • Peer Reviewed
• [Journal Article] Variations in the preoperative resources use and the practice pattern in Japanese cholecystectomy patients (2010)
  • Author(s): Kuwabara K., Matsuda S., Fushimi K., Ishikawa KB., Horiguchi H., Fujimori K.
  • Journal Title: Surg Today Volume: 40 Pages: 334-346
  • NAID: 10027395123
  • Peer Reviewed
• [Journal Article] Impact of timing of bile duct interventions on resource use and clinical outcome of cholecystectomy patients in Japa (2010)
  • Author(s): Kuwabara K., Matsuda S., Fushimi K., Ishikawa KB., Horiguchi H., Hayashida K., Fujimori, K
  • Journal Title: J Eval Clin Pract Volume: 16 Pages: 802-810
  • Peer Reviewed
• [Journal Article] Travel of patients to distant hospitals for elective surgery in Japan : A cross-sectional analysis of a nationally representative sample (2009)
  • Author(s): Yamamoto, K., Fushimi, K.
  • Journal Title: Surgery Today 39 Pages: 758-763
  • NAID: 10025134054
  • Peer Reviewed
• [Presentation] Relationship between short-term outcomes and hospital surgical volume of total hip arthroplasty in Japan (2012)
  • Author(s): Takeshi Kaneko, Kazuo Hirakawa, Kiyohide Fushimi
  • Organizer: Annual Meeting, American Academy of Orthopaedic Surgeons
  • Place of Presentation: San Francisco, USA
  • Year and Date: 2012-02-07
• [Presentation] The Impact of Comorbid Mental Illness on Costs of Health Care for Inpatients sith Heart Failure (2011)
  • Author(s): Shimizu, S., Ishikawa, KB., Ito, H., Fushimi, K.
  • Organizer: ISPOR 14th Annual European Congress
  • Place of Presentation: Madrid, Spain
  • Year and Date: 2011-11-05
• [Presentation] The Impact of Comorbid Mental Illness on Costs of Health Care for Inpatients sith Heart Failure (2011)
  • Author(s): Shimizu, S., Ishikawa, KB., Ito, H., Fushimi, K.
  • Organizer: ISPOR 14th Annual European Congress
  • Place of Presentation: Hotel Auditrium Madrid (Madrid, Spain)
  • Year and Date: 2011-11-05
• [Presentation] A look at the use of the Japaneses administrative database and the geographical information system in the management of disaster medicine and regional medical care planning (2011)
  • Author(s): Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K., Horiguchi, H., fujimori, K., Tasaki, T.
  • Organizer: 27th PCS/I Conference
  • Place of Presentation: Le Westin Montreal (Montreal, Quebec, Canada)
  • Year and Date: 2011-10-19
• [Presentation] Application of Agency for Healthcare Research and Quality (AHRQ) patient safety indicators in Japan (2011)
  • Author(s): Ikeda, S., Kobayashi, M., Fushimi, K., Matsuda, S.
  • Organizer: 28th ISQua Conference
  • Place of Presentation: Hong Kong Convention and Exhibition Centre (Hong Kong, China)
  • Year and Date: 2011-09-28
• [Presentation] The Development of clinical Indicators for acute care hospitals in Japan (2011)
  • Author(s): Kobayashi, M., Bito, S., Okada, C., Fushimi, K.
  • Organizer: 28th ISQua Conference
  • Place of Presentation: Hong Kong Convention and Exhibition Centre (Hong Kong, China)
  • Year and Date: 2011-09-28
• [Presentation] 大規模Administrative Databaseより抽出したVancomycin投与症例のTDM実施率がLOS(在院日数)に与える影響 (2011)
  • Author(s): 今井志乃ぶ,伏見清秀
  • Organizer: 第49回日本医療・病院管理学会学術総会
  • Place of Presentation: 東京
  • Year and Date: 2011-08-20
• [Presentation] 日本における人工股関節置換手術の周術期合併症と施設規模の関係 (2011)
  • Author(s): 金子剛士,伏見清秀
  • Organizer: 第49回日本医療・病院管理学会学術総会
  • Place of Presentation: 東京
  • Year and Date: 2011-08-20
• [Presentation] 大規模Administrative Databaseより抽出したVancomycin投与症例のTDM実施率がLOS(在院日数)に与える影響 (2011)
  • Author(s): 今井志乃ぶ, 伏見清秀
  • Organizer: 第49回日本医療・病院管理学会学術総会
  • Place of Presentation: 学術総合センター(東京都)
  • Year and Date: 2011-08-20
• [Presentation] 日本における人工股関節置換手術の周術期合併症と施設規模の関係 (2011)
  • Author(s): 金子剛士, 伏見清秀
  • Organizer: 第49回日本医療・病院管理学会学術総会
  • Place of Presentation: 学術総合センター(東京都)
  • Year and Date: 2011-08-20
• [Presentation] Health resource reallocation by case-mix data in Japan (2009)
  • Author(s): Fushimi, K., Matsuda, S
  • Organizer: 25th PCS/I Conference
  • Place of Presentation: Fukuoka, Japan
• [Presentation] Using Health GIS to evaluation of the regional diversity of the quality and efficiency of health case systems in Japan (2009)
  • Author(s): Shimizu, S., Fushimi, K
  • Organizer: 25th PCS/I Conference
  • Place of Presentation: Fukuoka, Japan
• [Book] DPCデータの臨床指標・病院指標への活用 (2011)
  • Author(s): 藤森研司、伏見清秀
  • Total Pages: 165
  • Publisher: じほう
• [Book] フランスにおける亜急性期入院医療を対象とした診断群分類の開発 (2011)
  • Author(s): 松田晋哉、伏見清秀
  • Publisher: 社会保険旬報
• [Book] DPCで見る地域医療の通信簿第1回 (2011)
  • Author(s): 伏見清秀
  • Total Pages: 1
  • Publisher: Japan Medicine
• [Book] DPCで見る地域医療の通信簿第2回 (2011)
  • Author(s): 伏見清秀
  • Total Pages: 1
  • Publisher: Japan Medicine
• [Book] DPCで見る地域医療の通信簿第3回 (2011)
  • Author(s): 伏見清秀
  • Total Pages: 1
  • Publisher: Japan Medicine
• [Book] DPCで見る地域医療の通信簿第4回 (2011)
  • Author(s): 伏見清秀
  • Total Pages: 1
  • Publisher: Japan Medicine
• [Book] DPCで見る地域医療の通信簿第5回 (2011)
  • Author(s): 伏見清秀
  • Total Pages: 1
  • Publisher: Japan Medicine
• [Book] DPCで見る地域医療の通信簿第6回 (2011)
  • Author(s): 伏見清秀
  • Total Pages: 1
  • Publisher: Japan Medicine
• [Book] DPCで見る地域医療の通信簿第7回 (2011)
  • Author(s): 伏見清秀
  • Total Pages: 1
  • Publisher: Japan Medicine
• [Book] DPCで見る地域医療の通信簿第8回 (2011)
  • Author(s): 伏見清秀
  • Total Pages: 1
  • Publisher: Japan Medicine
• [Book] DPCで見る地域医療の通信簿第9回 (2011)
  • Author(s): 伏見清秀
  • Total Pages: 1
  • Publisher: Japan Medicine
• [Book] DPCで見る地域医療の通信簿第10回 (2011)
  • Author(s): 伏見清秀
  • Total Pages: 1
  • Publisher: Medifax digest
• [Book] DPC包括評価制度の現状とDPC研究班の今までの研究 (2011)
  • Author(s): 伏見清秀
  • Publisher: 医事業務