| アブストラクト | Background: Cardiac rehabilitation (CR) is an evidence-based medical service for patients with acute myocardial infarction (AMI); however, its implementation is inadequate. We investigated the provision status and equality of CR by hospitals in Japan using a comprehensive nationwide claims database. Methods and Results: We analyzed data from the National Database of Health Insurance Claims and Specific Health Checkups in Japan for the period April 2014-March 2016. We identified patients aged >/=20 years with postintervention AMI. We calculated hospital-level proportions of inpatient and outpatient CR participation. The equality of hospital-level proportions of inpatient and outpatient CR participation was evaluated using the Gini coefficient. We included 35,298 patients from 813 hospitals for the analysis of inpatients and 33,328 patients from 799 hospitals for the analysis of outpatients. The median hospital-level proportions of inpatient and outpatient CR participation were 73.3% and 1.8%, respectively. The distribution of inpatient CR participation was bimodal; the Gini coefficients of inpatient and outpatient CR participation were 0.37 and 0.73, respectively. Although there were statistically significant differences in the hospital-level proportion of CR participation for several hospital factors, CR certification status for reimbursement was the only visually evident factor affecting the distribution of CR participation. Conclusions: The distributions of inpatient and outpatient CR participation by hospitals were suboptimal. Further research is warranted to determine future strategies. |
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| ジャーナル名 | Circulation reports |
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| 投稿日 | 2023/5/14 |
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| 投稿者 | Komiyama, Jun; Sugiyama, Takehiro; Iwagami, Masao; Ishimaru, Miho; Sun, Yu; Matsui, Hiroki; Kume, Keitaro; Sanuki, Masaru; Koyama, Teruyuki; Kato, Genta; Mori, Yukiko; Ueshima, Hiroaki; Tamiya, Nanako |
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| 組織名 | Graduate School of Comprehensive Human Sciences, University of Tsukuba Tsukuba;Japan.;Department of Health Services Research, Institute of Medicine, University of;Tsukuba Tsukuba Japan.;Health Services Research and Development Center, University of Tsukuba Tsukuba;Diabetes and Metabolism Information Center, Research Institute, National Center;for Global Health and Medicine Tokyo Japan.;Institute for Global Health Policy, Bureau of International Health Cooperation,;National Center for Global Health and Medicine Tokyo Japan.;Department of Oral Health Promotion, Graduate School of Medical and Dental;Sciences, Tokyo Medical and Dental University Tokyo Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, University of Tokyo Tokyo Japan.;Department of Clinical Medicine, University of Tsukuba Tsukuba Japan.;Department of Rehabilitation, Kameda Medical Center Kamogawa Japan.;Solutions Center for Health Insurance Claims, Kyoto University Hospital Kyoto;Division of Medical Information Technology and Administration Planning, Kyoto;University Hospital Kyoto Japan.;Center for Innovative Research and Education in Data Science, Institute for;Liberal Arts and Sciences, Kyoto University Kyoto Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37180473/ |
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