Development of quality indicators of stroke centers and feasibility of their measurement using a nationwide insurance claims database in Japan ― J-ASPECT study ―

Ataru Nishimura, Kunihiro Nishimura, Daisuke Onozuka, Ryu Matsuo, Akiko Kada, Satoru Kamitani, Takahiro Higashi, Kuniaki Ogasawara, Megumi Shimodozono, Masafumi Harada, Yoichiro Hashimoto, Teruyuki Hirano, Haruhiko Hoshino, Ryo Itabashi, Yoshiaki Itoh, Toru Iwama, Tatsuo Kohriyama, Yuji Matsumaru, Toshiaki Osato, Makoto SasakiYoshiaki Shiokawa, Hiroaki Shimizu, Hidehiro Takekawa, Toru Nishi, Masaaki Uno, Yoshiki Yagita, Keisuke Ido, Ai Kurogi, Ryota Kurogi, Koichi Arimura, Nice Ren, Akihito Hagihara, Shunya Takizawa, Hajime Arai, Takanari Kitazono, Susumu Miyamoto, Kazuo Minematsu, Koji Iihara

研究成果: ジャーナルへの寄稿記事

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Background: We aimed to develop quality indicators (QIs) related to primary and comprehensive stroke care and examine the feasibility of their measurement using the existing Diagnosis Procedure Combination (DPC) database. Methods and Results: We conducted a systematic review of domestic and international studies using the modified Delphi method. Feasibility of measuring the QI adherence rates was examined using a DPC-based nationwide stroke database (396,350 patients admitted during 2013–2015 to 558 hospitals participating in the J-ASPECT study). Associations between adherence rates of these QIs and hospital characteristics were analyzed using hierarchical logistic regression analysis. We developed 17 and 12 measures as QIs for primary and comprehensive stroke care, respectively. We found that measurement of the adherence rates of the developed QIs using the existing DPC database was feasible for the 6 QIs (primary stroke care: early and discharge antithrombotic drugs, mean 54.6% and 58.7%; discharge anticoagulation for atrial fibrillation, 64.4%; discharge antihypertensive agents, 51.7%; comprehensive stroke care: fasudil hydrochloride or ozagrel sodium for vasospasm prevention, 86.9%; death complications of diagnostic neuroangiography, 0.4%). We found wide inter-hospital variation in QI adherence rates based on hospital characteristics. Conclusions: We developed QIs for primary and comprehensive stroke care. The DPC database may allow efficient data collection at low cost and decreased burden to evaluate the developed QIs.

元の言語英語
ページ(範囲)2292-2302
ページ数11
ジャーナルCirculation Journal
83
発行部数11
DOI
出版物ステータス出版済み - 1 1 2019

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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