Cargando…
Impact of the Hospitalist System in Japan on the Quality of Care and Healthcare Economics
OBJECTIVE: The hospitalist system is considered successful with respect to the quality of care and cost effectiveness in the United States. Studies have consistently demonstrated an improved clinical efficiency with this system. In Japan, however, the efficacy of the hospitalist system has not yet b...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Society of Internal Medicine
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928496/ https://www.ncbi.nlm.nih.gov/pubmed/31391388 http://dx.doi.org/10.2169/internalmedicine.2872-19 |
_version_ | 1783482489827753984 |
---|---|
author | Hamada, Osamu Tsutsumi, Takahiko Tsunemitsu, Ayako Fukui, Takafumi Shimokawa, Toshio Imanaka, Yuichi |
author_facet | Hamada, Osamu Tsutsumi, Takahiko Tsunemitsu, Ayako Fukui, Takafumi Shimokawa, Toshio Imanaka, Yuichi |
author_sort | Hamada, Osamu |
collection | PubMed |
description | OBJECTIVE: The hospitalist system is considered successful with respect to the quality of care and cost effectiveness in the United States. Studies have consistently demonstrated an improved clinical efficiency with this system. In Japan, however, the efficacy of the hospitalist system has not yet been examined. As a “super-aged society”, Japan has a high number of elderly patients with multiple comorbidities who may theoretically receive better care by the hospitalist system than by the conventional system. This study investigates the impact of the hospitalist system on the quality of care and healthcare economics in a Japanese population. METHODS: We analyzed 274 patients ≥65 years of age in whom the most resource-consuming diagnosis at admission was aspiration pneumonia over a 1-year period. We categorized patients as those managed by hospitalists and those managed by various departments (control group) and compared the groups. Propensity score matching was used to minimize selection bias. RESULTS: For matched pairs, the length of hospital stay in the hospitalist group was shorter than that in the control group. Care by the hospitalist system was associated with significantly lower hospital costs. The quality of care (rate of switching from intravenous to oral antibiotics, duration of antibiotics therapy, number of chest X-rays and blood tests during hospitalization) was also considered to be favorably impacted by the hospitalist system. There was no statistically significant difference in the mortality rate or readmission rate between the groups. CONCLUSION: This study showed that the hospitalist system had a favorable impact on the quality of care and cost effectiveness, suggesting the potential utility of its implementation in the Japanese medical system. |
format | Online Article Text |
id | pubmed-6928496 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | The Japanese Society of Internal Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-69284962019-12-26 Impact of the Hospitalist System in Japan on the Quality of Care and Healthcare Economics Hamada, Osamu Tsutsumi, Takahiko Tsunemitsu, Ayako Fukui, Takafumi Shimokawa, Toshio Imanaka, Yuichi Intern Med Original Article OBJECTIVE: The hospitalist system is considered successful with respect to the quality of care and cost effectiveness in the United States. Studies have consistently demonstrated an improved clinical efficiency with this system. In Japan, however, the efficacy of the hospitalist system has not yet been examined. As a “super-aged society”, Japan has a high number of elderly patients with multiple comorbidities who may theoretically receive better care by the hospitalist system than by the conventional system. This study investigates the impact of the hospitalist system on the quality of care and healthcare economics in a Japanese population. METHODS: We analyzed 274 patients ≥65 years of age in whom the most resource-consuming diagnosis at admission was aspiration pneumonia over a 1-year period. We categorized patients as those managed by hospitalists and those managed by various departments (control group) and compared the groups. Propensity score matching was used to minimize selection bias. RESULTS: For matched pairs, the length of hospital stay in the hospitalist group was shorter than that in the control group. Care by the hospitalist system was associated with significantly lower hospital costs. The quality of care (rate of switching from intravenous to oral antibiotics, duration of antibiotics therapy, number of chest X-rays and blood tests during hospitalization) was also considered to be favorably impacted by the hospitalist system. There was no statistically significant difference in the mortality rate or readmission rate between the groups. CONCLUSION: This study showed that the hospitalist system had a favorable impact on the quality of care and cost effectiveness, suggesting the potential utility of its implementation in the Japanese medical system. The Japanese Society of Internal Medicine 2019-08-06 2019-12-01 /pmc/articles/PMC6928496/ /pubmed/31391388 http://dx.doi.org/10.2169/internalmedicine.2872-19 Text en Copyright © 2019 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Hamada, Osamu Tsutsumi, Takahiko Tsunemitsu, Ayako Fukui, Takafumi Shimokawa, Toshio Imanaka, Yuichi Impact of the Hospitalist System in Japan on the Quality of Care and Healthcare Economics |
title | Impact of the Hospitalist System in Japan on the Quality of Care and Healthcare Economics |
title_full | Impact of the Hospitalist System in Japan on the Quality of Care and Healthcare Economics |
title_fullStr | Impact of the Hospitalist System in Japan on the Quality of Care and Healthcare Economics |
title_full_unstemmed | Impact of the Hospitalist System in Japan on the Quality of Care and Healthcare Economics |
title_short | Impact of the Hospitalist System in Japan on the Quality of Care and Healthcare Economics |
title_sort | impact of the hospitalist system in japan on the quality of care and healthcare economics |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928496/ https://www.ncbi.nlm.nih.gov/pubmed/31391388 http://dx.doi.org/10.2169/internalmedicine.2872-19 |
work_keys_str_mv | AT hamadaosamu impactofthehospitalistsysteminjapanonthequalityofcareandhealthcareeconomics AT tsutsumitakahiko impactofthehospitalistsysteminjapanonthequalityofcareandhealthcareeconomics AT tsunemitsuayako impactofthehospitalistsysteminjapanonthequalityofcareandhealthcareeconomics AT fukuitakafumi impactofthehospitalistsysteminjapanonthequalityofcareandhealthcareeconomics AT shimokawatoshio impactofthehospitalistsysteminjapanonthequalityofcareandhealthcareeconomics AT imanakayuichi impactofthehospitalistsysteminjapanonthequalityofcareandhealthcareeconomics |