Journal article
Quality of care and in-hospital resource use in acute myocardial infarction: Evidence from Japan
Health policy (Amsterdam), v 111(3)
01 Aug 2013
PMID: 23800607
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objectives: To determine the association between quality of care in process and outcome measures and in-hospital resource use among patients admitted for acute myocardial infarction (AMI) in Japan.
Methods: We analyzed 23,512 AMI patients across 150 hospitals in Japan between April 2008 and March 2011. The exposure measure was inpatient hospital resource use, which was calculated from the sum of all hospital fees for healthcare services provided to AMI patients. Hospitals were then categorized into quartiles based on a risk-adjusted in-hospital resource use index. Quality of care was assessed using three process measures (in-hospital prescription of aspirin, beta-blockers, and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers) and two outcome measures (7-day and 30-day in-hospital mortality). Process and outcome measures were analyzed with multilevel logistic regression models that adjusted for patient and hospital characteristics.
Results: No significant differences in process measures were observed across the quartiles of in-hospital resource use. In contrast, hospitals with the lowest resource use were significantly associated with poorer outcomes (7-day in-hospital mortality OR: 1.851 [95% Cl 1.327-2.582]; 30-day in-hospital mortality OR: 1.706 [95% Cl 1.259-2.312]) than hospitals with higher resource use.
Conclusion: Poorer quality of care in outcome measures was significantly associated with lower resource utilization among AMI patients in Japanese hospitals, but process measures did not show similar associations. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
Metrics
Details
- Title
- Quality of care and in-hospital resource use in acute myocardial infarction: Evidence from Japan
- Creators
- Sungchul Park - Kyoto UniversityJason Lee - Kyoto UniversityHiroshi Ikai - Kyoto UniversityTetsuya Otsubo - Kyoto UniversityNaoto Ukawa - Kyoto UniversityYuichi Imanaka - Kyoto University
- Publication Details
- Health policy (Amsterdam), v 111(3)
- Publisher
- Elsevier
- Number of pages
- 9
- Grant note
- Ministry of Health, Labour and Welfare (MHLW); Ministry of Health, Labour and Welfare, Japan Japan Society for the Promotion of Science (JSPS); Ministry of Education, Culture, Sports, Science and Technology, Japan (MEXT); Japan Society for the Promotion of Science
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Health Management and Policy
- Web of Science ID
- WOS:000324282600007
- Scopus ID
- 2-s2.0-84882623299
- Other Identifier
- 991019296572004721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Health Care Sciences & Services
- Health Policy & Services