Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Hospitalization for ambulatory care sensitive conditions (ACSCs) is an indicator of the quality of primary care in different health systems. In Japan, where patients can choose any healthcare facility with universal health coverage (UHC), data on these admissions are unknown.
Objective: To describe the current situation of ACSC admissions in a city of Japan.
Design: Retrospective observational study using claims data.
Participants: Beneficiaries aged 0-74 years of the National Health Insurance (NHI) program in a large city in the Greater Tokyo Area. We extracted ACSC admissions from all inpatient claims between April 2013 and March 2017.
Main Measures: We calculated age- and sex-specific annual ACSC admission rates for three categories: acute, chronic, and vaccine-preventable. We estimated the age-adjusted admission rates by ACSC category according to administrative districts and rate ratios using Poisson regression models. We also estimated medical expenditures and lengths of stay for ACSC admissions.
Key Results: Of 91,350 hospitalization episodes, we identified 7666 (8.4%) that were ACSC admissions. Males had higher annual ACSC admission rates than females (p < 0.001), especially for chronic ACSCs. Admission rates were lowest in those aged 15-39 years and higher in the youngest (0-4 years) and oldest (70-74 years) age groups. Age-adjusted chronic ACSC admission rates were lower in a newly developed area (rate ratio [RR]: 0.79, 95% confidence interval [CI]: 0.71-0.87) and higher in a residential area (RR: 1.14, 95% CI: 1.04-1.24) than in the center of the city. Total medical expenditures for all ACSC admissions accounted for 5.8% of the total inpatient expenditures of NHI in the city.
Conclusions: ACSC admission rates in Japan were higher for males than for females and showed a U-shaped trend in terms of age, as in other countries with UHC, and deferred by region. This study provided possible factors to reduce ACSC admissions.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9640483 | PMC |
| http://dx.doi.org/10.1007/s11606-022-07713-z | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Short-Course Antibiotic Agent Therapy for Early Ventilator-Associated Pneumonia in Patients with Trauma.
Surg Infect (Larchmt)
September 2025
Department of Surgery, Division of Acute Care Surgery, University of Florida College of Medicine, Gainesville, Florida, USA.
Patients with traumatic injuries who develop ventilator-associated pneumonia (VAP) incur a higher risk of developing multi-drug resistance. Shorter duration of antibiotic agents for early VAP at five days may reduce antibiotic agent exposure without worsening patient outcomes. This retrospective cohort study performed at a Level I Trauma Center included adult (≥16 years old) patients with trauma diagnosed with bronchoalveolar lavage (BAL)-proven early (within four days of intubation) bacterial VAP.
View Article and Find Full Text PDFPatient Characteristics Associated with 30-Day Readmission to a Pediatric Cardiac Center.
Pediatr Cardiol
September 2025
Division of Cardiology, Children's National Hospital, 111 Michigan Ave, Washington, DC, 20010, USA.
Patients with acquired and congenital heart disease (CHD) are at higher risk of hospitalization. Despite quality improvement (QI) initiatives, many patients experience readmission soon after discharge. We aimed to identify risk factors for 30-day readmission and hypothesized that direct discharge from the cardiac intensive care unit (CICU) is associated with an increased readmission rate.
View Article and Find Full Text PDFEffect of an integrated care model on ST-segment elevation myocardial infarction management in China: a prospective, multicentre, non-randomised controlled study.
Heart
September 2025
Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China.
Background: Early reperfusion therapy is critical in patients with ST-segment elevation myocardial infarction (STEMI). However, limitations in resources and patient-level and system-level barriers delay the administration of reperfusion therapy. This study evaluated the impact of an integrated care strategy for STEMI management in China.
View Article and Find Full Text PDFImplementing relational continuity in general practice-understanding who needs it, when, to what extent, how and why: a realist review protocol.
BMJ Open
September 2025
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England, UK.
Introduction: Relational continuity of care (RCC) refers to the sustained therapeutic relationship between a patient and a clinician, which fosters trust, enhances communication and facilitates the accumulation of knowledge about the patient. RCC is associated with enhanced patient outcomes, reduced hospital admissions, lower mortality rates, decreased healthcare costs and improved patient experience. Despite these benefits, reorganisations within the NHS and workforce challenges have led to an increased reliance on multidisciplinary and part-time working, resulting in fragmented care and a decline in RCC.
View Article and Find Full Text PDFAssociation Between the Frailty Index Based on Laboratory Tests and All-Cause Mortality in Hospitalized Older Adults: Retrospective Cohort Study.
JMIR Aging
September 2025
Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer- Sheva, Israel.
Background: Frailty is a common issue among hospitalized older adult patients and is associated with numerous adverse health outcomes. Assessing frailty facilitates better decision-making for treatment plans, patient placement, and discharge planning. Approximately a decade ago, the frailty index based on laboratory tests (FI-Lab) metric was introduced.
View Article and Find Full Text PDF