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Impact of financial incentives for inter-provider care coordination on health-care resource utilization among elderly acute stroke patients.
International Journal for Quality in Health Care 2017 August 2
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.
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.
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