Tetsuya Otsubo

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OBJECTIVES To determine the association between quality of care in process and outcome measures and in-hospital resource use among patients admitted for acute myocardial infarction (AMI) in Japan. METHODS We analyzed 23,512 AMI patients across 150 hospitals in Japan between April 2008 and March 2011. The exposure measure was inpatient hospital resource(More)
OBJECTIVES Understanding of hospital cost is crucial to achieve an ideal balance between the assurance and improvement of patient safety and quality, and efficient use of finite resources. However, neither a standardized calculation methodology nor a large-scale database of costs in acute-care hospitals exists in Japan. This study aims to develop a(More)
BACKGROUND End-of-life (EOL) care imposes heavy economic burdens on patients and health insurers. Little is known about the association between the types of EOL care and healthcare costs for cancer patients across various providers. OBJECTIVE To explore the association of healthcare expenditures with benchmarking indicators of aggressive versus palliative(More)
BACKGROUND The shortage of physicians in Japan is a serious concern, particularly in specialties like pediatrics. The purpose of this study was to investigate recent changes in the geographic distribution of pediatricians and the factors underlying this change. METHODS We investigated the numerical changes in the pediatrician workforce (2002 to 2007) per(More)
BACKGROUND Intravenous tissue plasminogen activator (tPA) is an effective treatment for acute ischemic stroke if administered within a few hours of stroke onset. Because of this time restriction, tPA administration remains infrequent. Ambulance use is an effective strategy for increasing tPA administration but may be influenced by geographical factors. The(More)
RATIONALE, AIMS AND OBJECTIVES Japan has one of the highest numbers of high-cost medical devices installed relative to its population. While evaluations of the distribution of these devices traditionally involve simple population-based assessments, an indicator that includes the demand of these devices would more accurately reflect the situation. The(More)
BACKGROUND Stroke and other cerebrovascular diseases are a major cause of death and disability. Predicting in-hospital mortality in ischaemic stroke patients can help to identify high-risk patients and guide treatment approaches. Chart reviews provide important clinical information for mortality prediction, but are laborious and limiting in sample sizes.(More)
BACKGROUND Acute heart failure (AHF) with its high in-hospital mortality is an increasing burden on healthcare systems worldwide, and comparing hospital performance is required for improving hospital management efficiency. However, it is difficult to distinguish patient severity from individual hospital care effects. The aim of this study was to develop a(More)
BACKGROUND Healthcare-associated infections are a major cause for worsening in ischaemic stroke patients. In addition to increased morbidity and mortality, healthcare-associated infections also result in a potentially preventable increase in economic costs. AIMS The aim of this study was to identify healthcare-associated infection incidence in ischaemic(More)
BACKGROUND Little is known about the regional variations in ischemic stroke care in Japan. This study investigates the regional variations and associations among outcomes, care processes, spending, and physician workforce availability in acute ischemic stroke care. METHODS Using administrative claims data from National Claims Database, we identified(More)