Related Experiment Videos
Analysis of hospital charges for ischemic stroke in Fukuoka, Japan
Feng Tu1, Makoto Anan, Yutaka Kiyohara
1Department of Health Services Management and Policy, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. tufeng69@hotmail.com
Insights
Reducing length of hospital stay (LOHS) is key to lowering inpatient charges for ischemic stroke in Japan. This can be achieved by adjusting reimbursement policies to manage healthcare costs.
Area of Science:
- Medical Economics
- Neurology
- Health Services Research
Background:
- Ischemic stroke imposes a significant economic burden in Japan, with rapidly increasing healthcare expenditures.
- Understanding factors influencing inpatient charges is crucial for cost containment.
Purpose of the Study:
- To investigate medical services and demographic factors contributing to increased inpatient charges for ischemic stroke patients in Japan.
Main Methods:
- Retrospective analysis of 316 ischemic stroke patients discharged between 1995 and 1999.
- Data collected from medical records and the hospital Clinical Financial Information System (CFIS).
- Stepwise multiple regression model used to analyze factors influencing total charges.
Main Results:
- The average length of hospital stay (LOHS) was 33 days, with a mean charge of $9020 per patient.
- LOHS was the primary determinant of hospital charges (partial R2=0.5993, P=0.0001).
- Operations and angiography were also significant, though less influential, factors affecting charges.
Conclusions:
- A strong positive association exists between LOHS and inpatient charges for ischemic stroke.
- Shortening LOHS is critical for reducing healthcare costs associated with ischemic stroke.
- Reimbursement policy adjustments may be effective in reducing LOHS and associated charges.
Objectives:
Stroke is a heavy economic burden on individuals, society, and health services in Japan, where health expenditures are rising rapidly. The objective of the present study was to examine medical services and demographic factors associated with increased inpatient charges for ischemic stroke in Japan.
Subjects And Methods:
The study subjects were 316 patients with a principal diagnosis of acute ischemic stroke who were discharged from the National Kyushu Medical Center Hospital from 1 July 1995 through 31 June 1999. Demographic, clinical, and administrative data were retrospectively collected from medical records and the hospital Clinical Financial Information System (CFIS). The influence of social and medical factors on total charges was analyzed using the stepwise multiple regression model.
Results:
Among the total subjects, the mean (median) length of hospital stay (LOHS) was 33 (30) days (range, 2-155 days). The mean (median) hospital charge per patient was US dollars 9020 (dollars 7974) with a range of dollars 336-54,509. The distribution of charges was 42% for fundamental, 17% for injection therapies, 13% for radiological test, 11% for other laboratory examinations, 3% for drugs, and 3% for operations. Stepwise multiple regression analysis revealed that LOHS was the key determinant of the hospital charge (partial R2=0.5993, P=0.0001). Operations (P=0.0001) and angiography (P=0.03) were also independent but less contributory determinants of the hospital charge.
Conclusions:
LOHS was strongly, positively associated with inpatient charges for ischemic stroke in Japan. This implies that significant charge reductions are more likely to rely on shortening LOHS, which probably can be achieved by altering reimbursement policies.
Related Concept Videos
01:15Ischemic Stroke l: Introduction
01:29Stroke: Introduction and Types
01:17Hemorrhagic Stroke l: Introduction