Intensive Care Unit Occupancy in Japan, 2015–2018: A Nationwide Inpatient Database Study

Ohbe, Hiroyuki; Sasabuchi, Yusuke; Kumazawa, Ryosuke; Matsui, Hiroki; Yasunaga, Hideo

doi:10.2188/jea.je20210016

Cited by 17 publications

(15 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 27 Among the high-income countries, in 2017, South Korea was ranked third-lowest after Japan (7.3) in terms of the number of ICU beds per population. Ohbe, et al 28 reported that the 4-year mean ICU bed occupancy rate did not change from 2015 to 2018 in Japan. In contrast, our results revealed that the occupancy rate increased annually in South Korea.…”

Section: Discussionmentioning

confidence: 98%

Discrepancy between the Demand and Supply of Intensive Care Unit Beds in South Korea from 2011 to 2019: A Cross-Sectional Analysis

et al. 2021

View full text Add to dashboard Cite

Purpose Intensive care unit (ICU) bed availability is key to critical patient care. In many countries, older patients generally account for a significant proportion of hospitalizations and ICU admissions. Therefore, considering the rapidly increasing aging population in South Korea, it is important to establish whether the demand for critical care is currently met by available ICU beds. Materials and Methods We evaluated a 9-year trend in ICU bed supply and ICU length of stay in South Korea between 2011 and 2019 in a population-based cross-sectional analysis, using data from the Korean Health Insurance Review & Assessment Service and Statistics database. We described the changes in ICU bed rates in adult (≥20 years) and older adult (≥65 years) populations. ICU length of stay was categorized similarly and was used to predict future ICU bed demands. Results The ICU bed rate per 100000 adults increased from 18.5 in 2011 to 19.5 in 2019. In contrast, the ICU bed rate per 100000 older adults decreased from 127.6 in 2011 to 104.0 in 2019. ICU length of stay increased by 43.8% for adults and 55.6% for older adults. In 2019, the regional differences in the ICU bed rate nearly doubled, and the ICU length of stay increased six-fold. The ICU bed occupancy rate in South Korea is expected to rise to 102.7% in 2030. Conclusion The discrepancy between the demand and supply of ICU beds in South Korea requires urgent action to anticipate future ICU demands.

show abstract

Section: Discussionmentioning

confidence: 98%

Discrepancy between the Demand and Supply of Intensive Care Unit Beds in South Korea from 2011 to 2019: A Cross-Sectional Analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The database contains discharge abstracts and administrative claims data from voluntarily participating hospitals (18). In 2017, the database contained data for about 75% of all ICU beds and 70% of all HDU beds in Japan (17). This database includes the following patient-level data for all hospitalizations: demographic characteristics; diagnoses recoded with International Classification of Diseases , Tenth Revision (ICD-10) codes; daily procedures recorded using Japanese medical procedure codes; daily drug administrations; and admission and discharge status.…”

Section: Methodsmentioning

confidence: 99%

“…ICUs are the hospital units that provide the most advanced critical care, whereas high-dependency care units (HDUs) are the hospital units in which patient care levels and costs are between the levels found in the ICU and general ward (8). CCUs are the hospital units that provide critical care for patients with acute myocardial infarction using various structure and staffing models, and many hospitals in Japan currently use some beds in their ICUs and HDUs as CCU beds because Japan has no insurance reimbursement criteria that specify what qualifies as a CCU (11, 17). The current situation in Japan thus provides a unique opportunity to evaluate the structure and staffing model of CCUs by comparing patients treated in the ICU versus HDU.…”

mentioning

confidence: 99%

ICU Versus High-Dependency Care Unit for Patients With Acute Myocardial Infarction: A Nationwide Propensity Score-Matched Cohort Study

Ohbe

Matsui

Yasunaga

2022

Critical Care Medicine

Self Cite

View full text Add to dashboard Cite

To compare the outcomes of patients with acute myocardial infarction who were treated in ICUs versus high-dependency care units (HDUs). DESIGN:A nationwide, propensity score-matched, retrospective cohort study of a national administrative inpatient database in Japan from July 2010 to March 2018. SETTING:Six hundred sixty-six acute-care hospitals with ICU and/or HDU beds covering about 75% of all ICU beds and 70% of all HDU beds in Japan. PATIENTS:Adult patients who were hospitalized for acute myocardial infarction and admitted to the ICU or HDU on the day of hospital admission. Propensity score-matching analysis was performed to compare the inhospital mortality between patients treated in the ICU and HDU on the day of hospital admission. INTERVENTIONS: ICU or HDU admission on the day of hospital admission. MEASUREMENTS AND MAIN RESULTS:Of 135,142 eligible patients, 89,382 (66%) were admitted to the ICU and 45,760 (34%) were admitted to the HDU on the day of admission. After propensity score matching, there was no statistically significant difference in inhospital mortality between the ICU and HDU groups (5.0% vs 5.5%; difference, -0.5%; 95% CI, -1.0% to 0.1%). In the subgroup analyses, inhospital mortality was significantly lower in the ICU group than that in the HDU group among patients with Killip class IV (25.6% vs 28.4%; difference, -2.9%; 95% CI, -5.4% to -0.3%), patients who underwent intubation (40.0% vs 46.6%; difference, -6.6%; 95% CI, -10.6% to -2.7%), and patients who received mechanical circulatory support (21.8% vs 24.7%; difference, -2.8%; 95% CI, -5.5% to -0.2%). CONCLUSIONS:Critical care in the ICU compared with that in the HDU was not associated with reduced inhospital mortality among the entire cohort of patients with acute myocardial infarction but was associated with reduced inhospital mortality among the subsets of patients with Killip class IV, intubation, or mechanical circulatory support.

show abstract

“…The database contains discharge abstracts and administrative claims data from voluntarily participating hospitals [ 16 ]. In 2017, the database contained data for about 75% of all ICU beds and 70% of all HDU beds in Japan [ 15 ]. This database includes the following patient-level data for all hospitalizations: demographic characteristics; diagnoses recoded with International Classification of Diseases, Tenth Revision (ICD-10) codes; daily procedures recorded using Japanese medical procedure codes; daily drug administrations; and admission and discharge status.…”

Section: Methodsmentioning

confidence: 99%

“…ICUs are the hospital units that provide the most advanced critical care, whereas high-dependency care units (HDUs) are the hospital units in which patient care levels and costs are between the levels found in the ICU and general ward [ 7 ]. CICUs are the hospital units that provide critical care for patients with cardiovascular diseases using various structure and staffing models, and many Japanese hospitals currently use some beds in their ICUs and HDUs as CICU beds for patients with acute heart failure because of the lack of insurance reimbursement criteria that specify what qualifies as a CICU [ 8 , 9 , 15 ]. Therefore, the current situation in Japan can provide a unique opportunity to assess the structure and staffing model of CICUs.…”

Section: Introductionmentioning

confidence: 99%

Intensive care unit versus high-dependency care unit for patients with acute heart failure: a nationwide propensity score-matched cohort study

2021

Self Cite

View full text Add to dashboard Cite

Background A structure and staffing model similar to that in general intensive care unit (ICUs) is applied to cardiac intensive care unit (CICUs) for patients with acute heart failure. However, there is limited evidence on the structure and staffing model of CICUs. The present study aimed to assess whether critical care for patients with acute heart failure in the ICUs is associated with improved outcomes than care in the high-dependency care units (HDUs), the hospital units in which patient care levels and costs are between the levels found in the ICU and general ward. Methods This nationwide, propensity score-matched, retrospective cohort study was performed using a national administrative inpatient database in Japan. We identified all patients who were hospitalized for acute heart failure and admitted to the ICU or HDU on the day of hospital admission from April 2014 to March 2019. Propensity score-matching analysis was performed to compare the in-hospital mortality between acute heart failure patients treated in the ICU and HDU on the day of hospital admission. Results Of 202,866 eligible patients, 78,646 (39%) and 124,220 (61%) were admitted to the ICU and HDU, respectively, on the day of admission. After propensity score matching, there was no statistically significant difference in in-hospital mortality between patients who were admitted to the ICU and HDU on the day of admission (10.7% vs. 11.4%; difference, − 0.6%; 95% confidence interval, − 1.5% to 0.2%). In the subgroup analyses, there was a statistically significant difference in in-hospital mortality between the ICU and HDU groups among patients receiving noninvasive ventilation (9.4% vs. 10.5%; difference, − 1.0%; 95% confidence interval, − 1.9% to − 0.1%) and patients receiving intubation (32.5% vs. 40.6%; difference, − 8.0%; 95% confidence interval, − 14.5% to − 1.5%). There were no statistically significant differences in other subgroup analyses. Conclusions Critical care in ICUs was not associated with lower in-hospital mortality than critical care in HDUs among patients with acute heart failure. However, critical care in ICUs was associated with lower in-hospital mortality than critical care in HDUs among patients receiving noninvasive ventilation and intubation.

show abstract

Intensive Care Unit Occupancy in Japan, 2015–2018: A Nationwide Inpatient Database Study

Cited by 17 publications

References 32 publications

Discrepancy between the Demand and Supply of Intensive Care Unit Beds in South Korea from 2011 to 2019: A Cross-Sectional Analysis

Discrepancy between the Demand and Supply of Intensive Care Unit Beds in South Korea from 2011 to 2019: A Cross-Sectional Analysis

ICU Versus High-Dependency Care Unit for Patients With Acute Myocardial Infarction: A Nationwide Propensity Score-Matched Cohort Study

Intensive care unit versus high-dependency care unit for patients with acute heart failure: a nationwide propensity score-matched cohort study

Contact Info

Product

Resources

About