TY - JOUR
T1 - Impact of financial incentives for inter-provider care coordination on health-care resource utilization among elderly acute stroke patients
AU - Nishi, Takumi
AU - Maeda, Toshiki
AU - Babazono, Akira
N1 - Funding Information:
This study was supported by Japan Society for the Promotion of Science [Grant-in-Aid for Scientific Research; grant number: 15H06921].
Publisher Copyright:
© The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved.
PY - 2017/8
Y1 - 2017/8
N2 - Objective: To examine the impact of inter-provider care coordination on health-care resource utilization among elderly acute stroke patients. Design: A retrospective cohort study using health-care insurance claims data. Setting: Claims data of the Fukuoka Prefecture Wide-Area Association of Latter-Stage Elderly Healthcare. Participants: About, 6409 patients aged 75 years or older admitted for acute stroke and moved to rehabilitation wards from 1 April 2010 to 30 September 2015. Main outcome measure: Lengths of stay (LOS) and total charge (TC) were evaluated according to three groups of care pathways (coordinated care, integrated care and other pathways). Results: Compared with the other care pathway, the coordinated care groups had significantly shorter LOS of 2.0 days in acute ischemic stroke care; they had 2.5 days shorter LOS in hemorrhagic stroke care. However, there were no significant differences in rehabilitation care LOS and TC. Conclusions: Our findings suggest that a payment system for care coordination is inappropriate since it was not associated with a reduction in overall health-care resource utilization. Further, health-care system reform is necessary to improve care continuity across multiple health-care institutions in Japan.
AB - Objective: To examine the impact of inter-provider care coordination on health-care resource utilization among elderly acute stroke patients. Design: A retrospective cohort study using health-care insurance claims data. Setting: Claims data of the Fukuoka Prefecture Wide-Area Association of Latter-Stage Elderly Healthcare. Participants: About, 6409 patients aged 75 years or older admitted for acute stroke and moved to rehabilitation wards from 1 April 2010 to 30 September 2015. Main outcome measure: Lengths of stay (LOS) and total charge (TC) were evaluated according to three groups of care pathways (coordinated care, integrated care and other pathways). Results: Compared with the other care pathway, the coordinated care groups had significantly shorter LOS of 2.0 days in acute ischemic stroke care; they had 2.5 days shorter LOS in hemorrhagic stroke care. However, there were no significant differences in rehabilitation care LOS and TC. Conclusions: Our findings suggest that a payment system for care coordination is inappropriate since it was not associated with a reduction in overall health-care resource utilization. Further, health-care system reform is necessary to improve care continuity across multiple health-care institutions in Japan.
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U2 - 10.1093/intqhc/mzx053
DO - 10.1093/intqhc/mzx053
M3 - Article
C2 - 28486581
AN - SCOPUS:85030451538
SN - 1353-4505
VL - 29
SP - 490
EP - 498
JO - International Journal for Quality in Health Care
JF - International Journal for Quality in Health Care
IS - 4
ER -
