Cargando…
Development and usability of a hospital standardized ADL ratio (HSAR) for elderly patients with cerebral infarction: a retrospective observational study using administrative claim data from 2012 to 2019 in Japan
BACKGROUND: Maintenance of activities of daily living (ADL) during acute hospitalization is an important treatment goal, especially for elderly inpatients with diseases that often leave disabilities, such as cerebral infarction. However, studies assessing risk-adjusted ADL changes are limited. In th...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10114477/ https://www.ncbi.nlm.nih.gov/pubmed/37072735 http://dx.doi.org/10.1186/s12877-023-03957-4 |
_version_ | 1785028023136813056 |
---|---|
author | Onishi, Ryo Hatakeyama, Yosuke Hirata, Koki Matsumoto, Kunichika Seto, Kanako Wu, Yinghui Kitazawa, Takefumi Hasegawa, Tomonori |
author_facet | Onishi, Ryo Hatakeyama, Yosuke Hirata, Koki Matsumoto, Kunichika Seto, Kanako Wu, Yinghui Kitazawa, Takefumi Hasegawa, Tomonori |
author_sort | Onishi, Ryo |
collection | PubMed |
description | BACKGROUND: Maintenance of activities of daily living (ADL) during acute hospitalization is an important treatment goal, especially for elderly inpatients with diseases that often leave disabilities, such as cerebral infarction. However, studies assessing risk-adjusted ADL changes are limited. In this study, we developed and calculated a hospital standardized ADL ratio (HSAR) using Japanese administrative claims data to measure the quality of hospitalization care for patients with cerebral infarction. METHODS: This study was designed as a retrospective observational study using the Japanese administrative claim data from 2012 to 2019. The data of all hospital admissions with a primary diagnosis of cerebral infarction (ICD-10, I63) were used. The HSAR was defined as the ratio of the observed number of ADL maintenance patients to the expected number of ADL maintenance patients multiplied by 100, and ratio of ADL maintenance patients was risk-adjusted using multivariable logistic regression analyses. The c-statistic was used to evaluate the predictive accuracy of the logistic models. Changes in HSARs in each consecutive period were assessed using Spearman’s correlation coefficient. RESULTS: A total of 36,401 patients from 22 hospitals were included in this study. All variables used in the analyses were associated with ADL maintenance, and evaluations using the HSAR model showed predictive ability with c-statistics (area under the curve, 0.89; 95% confidence interval, 0.88–0.89). CONCLUSIONS: The findings indicated a need to support hospitals with a low HSAR because hospitals with high/low HSAR were likely to produce the same results in the subsequent periods. HSAR can be used as a new quality indicator of in-hospital care and may contribute to the assessment and improvement of the quality of care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-03957-4. |
format | Online Article Text |
id | pubmed-10114477 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-101144772023-04-20 Development and usability of a hospital standardized ADL ratio (HSAR) for elderly patients with cerebral infarction: a retrospective observational study using administrative claim data from 2012 to 2019 in Japan Onishi, Ryo Hatakeyama, Yosuke Hirata, Koki Matsumoto, Kunichika Seto, Kanako Wu, Yinghui Kitazawa, Takefumi Hasegawa, Tomonori BMC Geriatr Research BACKGROUND: Maintenance of activities of daily living (ADL) during acute hospitalization is an important treatment goal, especially for elderly inpatients with diseases that often leave disabilities, such as cerebral infarction. However, studies assessing risk-adjusted ADL changes are limited. In this study, we developed and calculated a hospital standardized ADL ratio (HSAR) using Japanese administrative claims data to measure the quality of hospitalization care for patients with cerebral infarction. METHODS: This study was designed as a retrospective observational study using the Japanese administrative claim data from 2012 to 2019. The data of all hospital admissions with a primary diagnosis of cerebral infarction (ICD-10, I63) were used. The HSAR was defined as the ratio of the observed number of ADL maintenance patients to the expected number of ADL maintenance patients multiplied by 100, and ratio of ADL maintenance patients was risk-adjusted using multivariable logistic regression analyses. The c-statistic was used to evaluate the predictive accuracy of the logistic models. Changes in HSARs in each consecutive period were assessed using Spearman’s correlation coefficient. RESULTS: A total of 36,401 patients from 22 hospitals were included in this study. All variables used in the analyses were associated with ADL maintenance, and evaluations using the HSAR model showed predictive ability with c-statistics (area under the curve, 0.89; 95% confidence interval, 0.88–0.89). CONCLUSIONS: The findings indicated a need to support hospitals with a low HSAR because hospitals with high/low HSAR were likely to produce the same results in the subsequent periods. HSAR can be used as a new quality indicator of in-hospital care and may contribute to the assessment and improvement of the quality of care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-03957-4. BioMed Central 2023-04-18 /pmc/articles/PMC10114477/ /pubmed/37072735 http://dx.doi.org/10.1186/s12877-023-03957-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Onishi, Ryo Hatakeyama, Yosuke Hirata, Koki Matsumoto, Kunichika Seto, Kanako Wu, Yinghui Kitazawa, Takefumi Hasegawa, Tomonori Development and usability of a hospital standardized ADL ratio (HSAR) for elderly patients with cerebral infarction: a retrospective observational study using administrative claim data from 2012 to 2019 in Japan |
title | Development and usability of a hospital standardized ADL ratio (HSAR) for elderly patients with cerebral infarction: a retrospective observational study using administrative claim data from 2012 to 2019 in Japan |
title_full | Development and usability of a hospital standardized ADL ratio (HSAR) for elderly patients with cerebral infarction: a retrospective observational study using administrative claim data from 2012 to 2019 in Japan |
title_fullStr | Development and usability of a hospital standardized ADL ratio (HSAR) for elderly patients with cerebral infarction: a retrospective observational study using administrative claim data from 2012 to 2019 in Japan |
title_full_unstemmed | Development and usability of a hospital standardized ADL ratio (HSAR) for elderly patients with cerebral infarction: a retrospective observational study using administrative claim data from 2012 to 2019 in Japan |
title_short | Development and usability of a hospital standardized ADL ratio (HSAR) for elderly patients with cerebral infarction: a retrospective observational study using administrative claim data from 2012 to 2019 in Japan |
title_sort | development and usability of a hospital standardized adl ratio (hsar) for elderly patients with cerebral infarction: a retrospective observational study using administrative claim data from 2012 to 2019 in japan |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10114477/ https://www.ncbi.nlm.nih.gov/pubmed/37072735 http://dx.doi.org/10.1186/s12877-023-03957-4 |
work_keys_str_mv | AT onishiryo developmentandusabilityofahospitalstandardizedadlratiohsarforelderlypatientswithcerebralinfarctionaretrospectiveobservationalstudyusingadministrativeclaimdatafrom2012to2019injapan AT hatakeyamayosuke developmentandusabilityofahospitalstandardizedadlratiohsarforelderlypatientswithcerebralinfarctionaretrospectiveobservationalstudyusingadministrativeclaimdatafrom2012to2019injapan AT hiratakoki developmentandusabilityofahospitalstandardizedadlratiohsarforelderlypatientswithcerebralinfarctionaretrospectiveobservationalstudyusingadministrativeclaimdatafrom2012to2019injapan AT matsumotokunichika developmentandusabilityofahospitalstandardizedadlratiohsarforelderlypatientswithcerebralinfarctionaretrospectiveobservationalstudyusingadministrativeclaimdatafrom2012to2019injapan AT setokanako developmentandusabilityofahospitalstandardizedadlratiohsarforelderlypatientswithcerebralinfarctionaretrospectiveobservationalstudyusingadministrativeclaimdatafrom2012to2019injapan AT wuyinghui developmentandusabilityofahospitalstandardizedadlratiohsarforelderlypatientswithcerebralinfarctionaretrospectiveobservationalstudyusingadministrativeclaimdatafrom2012to2019injapan AT kitazawatakefumi developmentandusabilityofahospitalstandardizedadlratiohsarforelderlypatientswithcerebralinfarctionaretrospectiveobservationalstudyusingadministrativeclaimdatafrom2012to2019injapan AT hasegawatomonori developmentandusabilityofahospitalstandardizedadlratiohsarforelderlypatientswithcerebralinfarctionaretrospectiveobservationalstudyusingadministrativeclaimdatafrom2012to2019injapan |