Regional differences in performance of bone marrow transplantation, care-resource use and outcome for adult T-cell leukaemia in Japan

Toshiki Maeda, Akira Babazono, Takumi Nishi, Shinya Matsuda, Kiyohide Fushimi, Kenji Fujimori

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Japan has a high prevalence of adult T-cell leukaemia (ATL), especially in the Kyushu/Okinawa region. Regional differences in prevalence might cause regional differences in physicians' experiences and the efficiency of care-resource use. This study investigated regional differences in the performance of bone marrow transplantation (BMT), outcome and care-resource use in patients with ATL in Japan. Methods. This was a cross-sectional study using a Japanese hospital administrative database in 2010, with a diagnostic-procedure combination/per diem payment system. We examined the association between BMT performance, resource use, outcomes and region. Results: We analysed data for 712 subjects of whom 60.5% were Kyushu/Okinawa residents. Significantly more patients with ATL underwent BMT in Kanto (p = 0.018) and Kansai (p < 0.001) regions compared with the Kyushu/Okinawa regions. The lengths of hospital stay were longer in Kanto (p = 0.002) and Kansai (p = 0.006) regions than in the Kyushu/Okinawa region. Total health-care costs were higher in Kanto (p = 0.001) and Kansai (p = 0.005) regions than the Kyushu/Okinawa region. The risks of in hospital mortality were not significantly different between regions. Conclusions: There were significant regional differences in BMT performance and resource use within Japan. ATL prevalence was not related to the performance of BMTs, resource use or outcomes. Factors related to regional socioeconomics might affect the performance of BMTs and care resource use within Japan.

Original languageEnglish
Article number337
JournalBMC Health Services Research
Volume14
Issue number1
DOIs
Publication statusPublished - Aug 8 2014

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Adult T Cell Leukemia Lymphoma
Bone Marrow Transplantation
Japan
Length of Stay
Hospital Mortality
Health Care Costs
Cross-Sectional Studies
Databases
Physicians

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

Regional differences in performance of bone marrow transplantation, care-resource use and outcome for adult T-cell leukaemia in Japan. / Maeda, Toshiki; Babazono, Akira; Nishi, Takumi; Matsuda, Shinya; Fushimi, Kiyohide; Fujimori, Kenji.

In: BMC Health Services Research, Vol. 14, No. 1, 337, 08.08.2014.

Research output: Contribution to journalArticle

Maeda, Toshiki ; Babazono, Akira ; Nishi, Takumi ; Matsuda, Shinya ; Fushimi, Kiyohide ; Fujimori, Kenji. / Regional differences in performance of bone marrow transplantation, care-resource use and outcome for adult T-cell leukaemia in Japan. In: BMC Health Services Research. 2014 ; Vol. 14, No. 1.
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N2 - Background: Japan has a high prevalence of adult T-cell leukaemia (ATL), especially in the Kyushu/Okinawa region. Regional differences in prevalence might cause regional differences in physicians' experiences and the efficiency of care-resource use. This study investigated regional differences in the performance of bone marrow transplantation (BMT), outcome and care-resource use in patients with ATL in Japan. Methods. This was a cross-sectional study using a Japanese hospital administrative database in 2010, with a diagnostic-procedure combination/per diem payment system. We examined the association between BMT performance, resource use, outcomes and region. Results: We analysed data for 712 subjects of whom 60.5% were Kyushu/Okinawa residents. Significantly more patients with ATL underwent BMT in Kanto (p = 0.018) and Kansai (p < 0.001) regions compared with the Kyushu/Okinawa regions. The lengths of hospital stay were longer in Kanto (p = 0.002) and Kansai (p = 0.006) regions than in the Kyushu/Okinawa region. Total health-care costs were higher in Kanto (p = 0.001) and Kansai (p = 0.005) regions than the Kyushu/Okinawa region. The risks of in hospital mortality were not significantly different between regions. Conclusions: There were significant regional differences in BMT performance and resource use within Japan. ATL prevalence was not related to the performance of BMTs, resource use or outcomes. Factors related to regional socioeconomics might affect the performance of BMTs and care resource use within Japan.

AB - Background: Japan has a high prevalence of adult T-cell leukaemia (ATL), especially in the Kyushu/Okinawa region. Regional differences in prevalence might cause regional differences in physicians' experiences and the efficiency of care-resource use. This study investigated regional differences in the performance of bone marrow transplantation (BMT), outcome and care-resource use in patients with ATL in Japan. Methods. This was a cross-sectional study using a Japanese hospital administrative database in 2010, with a diagnostic-procedure combination/per diem payment system. We examined the association between BMT performance, resource use, outcomes and region. Results: We analysed data for 712 subjects of whom 60.5% were Kyushu/Okinawa residents. Significantly more patients with ATL underwent BMT in Kanto (p = 0.018) and Kansai (p < 0.001) regions compared with the Kyushu/Okinawa regions. The lengths of hospital stay were longer in Kanto (p = 0.002) and Kansai (p = 0.006) regions than in the Kyushu/Okinawa region. Total health-care costs were higher in Kanto (p = 0.001) and Kansai (p = 0.005) regions than the Kyushu/Okinawa region. The risks of in hospital mortality were not significantly different between regions. Conclusions: There were significant regional differences in BMT performance and resource use within Japan. ATL prevalence was not related to the performance of BMTs, resource use or outcomes. Factors related to regional socioeconomics might affect the performance of BMTs and care resource use within Japan.

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