Infectious disease during hospitalization is the major causative factor for prolonged hospitalization: multivariate analysis of diagnosis procedure combination (DPC) data of 20,876 cases in Japan

Abstract

This study aimed to evaluate causative factors for prolonged hospitalization based on hospitalization status, type of hospital ward, and comorbidities, specifically diabetes mellitus and infectious diseases, in 20,876 patients hospitalized in Saga University Hospital from April 1, 2012, to February 28, 2015. Prolonged hospitalization was defined as hospital days exceeding period 3 in the diagnosis procedure combination system. Among all factors, causative (risk) factors for prolonged hospitalization were evaluated by multiple logistic regression analysis. Multivariate analysis indicated causative factors for prolonged hospitalization were aging, comorbid diabetes mellitus, time spent in the intensive care unit, and infectious diseases contracted during hospitalization. The risk factors for contracting infectious diseases during hospitalization were aging, male sex, comorbid diabetes mellitus, and increased number of days spent in period 3 in the diagnosis procedure combination code. These data indicated that critical factors for discharge from hospital within an appropriate time frame were prevention of infectious diseases during hospitalization, and a fast and effective therapeutic approach to patients in the intensive care unit.

A Study on the Status of Proton Pump Inhibitor Prescriptions Using Diagnosis Procedure Combination Data in Japan

“…It also regulates the hospitalization period in each DPC code. The DPC survey data consist of patient information and other supplemental information, in addition to information on the diagnostic groups and treatment [14]. Therefore, the DPC enables analysis of the details of the PPI prescription status in hospitalized patients.…”

High Cost of Hospitalization for Colonic Diverticular Bleeding Depended on Repeated Bleeding and Blood Transfusion: Analysis with Diagnosis Procedure Combination Data in Japan

“…The DPC system was introduced in 2003 in Japanese medical hospitals authorized to treat patients with health insurance [13,14]. This system was used in 55% of all general sickbeds in 1,585 hospitals with a total of 492,256 sickbeds [14]. The main purpose of introducing the DPC system into intensive care hospitals in Japan is to maintain the performance of above-average medical care [13,14].…”

“…This system was used in 55% of all general sickbeds in 1,585 hospitals with a total of 492,256 sickbeds [14]. The main purpose of introducing the DPC system into intensive care hospitals in Japan is to maintain the performance of above-average medical care [13,14]. The DPC system regulates diagnostic and therapeutic approaches in each DPC code for the standardization of medical care; it also regulates the hospitalization period in each DPC code.…”

“…The diagnosis procedure combination (DPC) database is available for the objective evaluation of medical costs in Japan. The DPC system was introduced in 2003 in Japanese medical hospitals authorized to treat patients with health insurance [13,14]. This system was used in 55% of all general sickbeds in 1,585 hospitals with a total of 492,256 sickbeds [14].…”

“…The DPC system regulates diagnostic and therapeutic approaches in each DPC code for the standardization of medical care; it also regulates the hospitalization period in each DPC code. In the DPC, hospital days are set for every identical diagnostic classification (DPC code) as follows: period 1: <25th percentile of hospital days, period 2: <50th percentile of hospital days, and period 3: within the mean ± 2 SDs [14]. …”