Impact of a national medical fee schedule revision on the cessation of physician home visits among older patients in Tokyo: A retrospective study

Chie Teramoto, Tatsuro Ishizaki, Seigo Mitsutake, Haruhisa Fukuda, Takashi Naruse, Sayuri Shimizu, Hideki Ito

研究成果: Contribution to journalArticle査読

1 被引用数 (Scopus)

抄録

As Japan's population continues to age rapidly, the national government has implemented several measures to improve the efficiency of healthcare services and to control rising medical expenses for older patients. One such measure was the revision of the medical fee schedule for physician home visits in April 2014, in which eligibility for these visits was restricted to patients who are unable to visit outpatient clinics without assistance. Through an investigation of patients who were receiving physician home visits in Tokyo, this study examines whether this fee schedule revision resulted in an increase in patients who transitioned from home visits to outpatient care. In a retrospective analysis of health insurance claims data, we examined 80,914 Tokyo residents aged 75 years or older who had received at least one physician home visit between January and May 2014. The study period was divided into four periods (January–February, February–March, March–April, and April–May), and we examined the number of patients receiving home visits in the index month of each period who subsequently transitioned to outpatient care in the following month. Potential factors associated with this transition to outpatient care were examined using a generalised estimating equation. The March–April period that included the fee schedule revision was significantly associated with a higher number of patients who transitioned from home visits in the index month to outpatient care in the following month (odds ratio: 4.46, p < 0.001) than the other periods. In addition, patients receiving home visits at residential facilities were more likely to transition to outpatient care (odds ratio: 10.40, p < 0.001). These findings indicate that the fee schedule revision resulted in an increase in patients who ceased physician home visits and began visiting outpatient clinics for treatment.

本文言語英語
ページ(範囲)899-906
ページ数8
ジャーナルHealth and Social Care in the Community
27
4
DOI
出版ステータス出版済み - 7 2019

All Science Journal Classification (ASJC) codes

  • 社会科学(その他)
  • 社会学および政治科学
  • 健康政策
  • 公衆衛生学、環境および労働衛生

フィンガープリント

「Impact of a national medical fee schedule revision on the cessation of physician home visits among older patients in Tokyo: A retrospective study」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

引用スタイル