Hongsoo Kim1, Shou-Hsia Cheng2, Hayato Yamana3, Seyune Lee4, Nan-He Yoon5, Yi-Chieh Lin6, Kiyohide Fushimi7, Hideo Yasunaga8. 1. Graduate School of Public Health Department of Public Health Science, Institute of Health and Environment, & Institute of Aging, Seoul National University, Seoul, 08826, South Korea. hk65@snu.ac.kr. 2. Institute of Health Policy and Management, College of Public Health, Population Health Research Center, National Taiwan University, Taipei, Taiwan. 3. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 4. Graduate School of Public Health, Department of Public Health Sciences, Seoul National University, Seoul, South Korea. 5. Division of Social Welfare and Health Administration, Wonkwang University, Iksan, Jeonbuk, South Korea. 6. Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan. 7. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan. 8. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Abstract
BACKGROUND: Little is known about hip fracture inpatient care in East Asia. This study examined the characteristics of patients, hospitals, and regions associated with delivery of hip fracture surgeries across Japan, Korea, and Taiwan. We also analyzed and compared how the resource use and a short-term outcome of the care in index hospitals varied according to factors in the respective health systems. METHODS: We developed comparable, nationwide, individual-level health insurance claims datasets linked with hospital- and regional-level statistics across the health systems using common protocols. Generalized linear multi-level analyses were conducted on length of stay (LOS) and total cost of index hospitalization as well as inpatient death. RESULTS: The majority of patients were female and aged 75 or older. The standardized LOS of the hospitalization for hip fracture surgery was 32.5 (S.D. = 18.7) days in Japan, 24.7 (S.D. = 12.4) days in Korea, and 7.1 (S.D. = 2.9) days in Taiwan. The total cost per admission also widely varied across the systems. Hospitals with a high volume of hip fracture surgeries had a lower LOS across all three systems, while other factors associated with LOS and total cost varied across countries. CONCLUSION: There were wide variations in resource use for hip fracture surgery in the index hospital within and across the three health systems with similar social health insurance schemes in East Asia. Further investigations into the large variations are necessary, along with efforts to overcome the methodological challenges of international comparisons of health system performance.
BACKGROUND: Little is known about hip fracture inpatient care in East Asia. This study examined the characteristics of patients, hospitals, and regions associated with delivery of hip fracture surgeries across Japan, Korea, and Taiwan. We also analyzed and compared how the resource use and a short-term outcome of the care in index hospitals varied according to factors in the respective health systems. METHODS: We developed comparable, nationwide, individual-level health insurance claims datasets linked with hospital- and regional-level statistics across the health systems using common protocols. Generalized linear multi-level analyses were conducted on length of stay (LOS) and total cost of index hospitalization as well as inpatient death. RESULTS: The majority of patients were female and aged 75 or older. The standardized LOS of the hospitalization for hip fracture surgery was 32.5 (S.D. = 18.7) days in Japan, 24.7 (S.D. = 12.4) days in Korea, and 7.1 (S.D. = 2.9) days in Taiwan. The total cost per admission also widely varied across the systems. Hospitals with a high volume of hip fracture surgeries had a lower LOS across all three systems, while other factors associated with LOS and total cost varied across countries. CONCLUSION: There were wide variations in resource use for hip fracture surgery in the index hospital within and across the three health systems with similar social health insurance schemes in East Asia. Further investigations into the large variations are necessary, along with efforts to overcome the methodological challenges of international comparisons of health system performance.
Authors: Juan F Blanco; Carmen da Casa; Rodrigo Sánchez de Vega; María Agustina Hierro-Estévez; Alfonso González-Ramírez; Carmen Pablos-Hernández Journal: Aging Clin Exp Res Date: 2020-01-23 Impact factor: 3.636
Authors: Seth M Tarrant; Ji Wan Kim; Takashi Matsushita; Hiroaki Minehara; Tomoyuki Noda; Jong-Keon Oh; Ki Chul Park; Noriaki Yamamoto; Zsolt J Balogh Journal: OTA Int Date: 2022-06-09