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.
All Science Journal Classification (ASJC) codes
- Health Policy
- Public Health, Environmental and Occupational Health