Management patterns and healthcare costs for hospitalized patients with cerebral infarction.
OBJECTIVE
Although evidence shows the importance of specialized intensive care of patients with cerebral infarction, it is not well known whether resources are generously applied in the initial period and how patterns of medical resource utilization are associated with characteristics of providers and patient outcomes. In this study, we analyzed changing patterns of daily medical cost using administrative healthcare claim data and identified a management pattern in each case.


METHODS
We used Japan's administrative data to identify medical costs on a day-to-day basis. Data of 3136 patients with acute cerebral infarction from 14 medical institutions were included in the analyses. Using the data, we calculated the costs from the perspective of the third-party payer. Institutions were divided into three groups according to the distribution of medical costs in the first 2 days, and patient background, treatment process, and outcomes were compared across the groups.


RESULTS
Medical cost was not necessarily intensively allocated during the early hospitalization period. Wide variations were observed in medical cost utilization patterns across institutions. The differences in medical cost for the initial hospitalization period appears to be more influenced by ICU utilization and management policies of institutions than the clinical condition of patients.


CONCLUSIONS
We proposed a methodology that uses administrative claim data to examine management patterns of ischemic stroke. We believe that the use of our method, in conjunction with accurate and detailed clinical data, can help elucidate the relationship among acute-period medical resource utilization, process of care, and patient outcomes.
Sekimoto
Miho
M
Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Kakutani
Chieko
C
Inoue
Isao
I
Ishizaki
Tatsuro
T
Hayashida
Kenshi
K
Imanaka
Yuichi
Y
D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000191:economics*; D017281:Cost of Illness; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007297:Inpatients; D007362:Intensive Care Units; D007564:Japan; D007902:Length of Stay / Q000191:economics; D008297:Male; D008485:Medical Audit / Q000191:economics; D008875:Middle Aged