Evaluations of Transcervical Fracture Treatments by the Discrete-Type Proportion Hazard and Ordered Probit Models

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  • 離散型比例ハザード・モデルと順序プロビット・モデルによる大腿骨頚部骨折における在院日数と退院時歩行能力の分析
  • リサンガタ ヒレイ ハザード モデル ト ジュンジョ プロビット モデル ニ ヨル ダイタイコツ ケイブ コッセツ ニ オケル ザイイン ニッスウ ト タイインジ ホコウ ノウリョク ノ ブンセキ

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Abstract

Rapid expansion of medical care expenses has become a major problem in Japan, and shortening the average length of stay (ALOS) by reducing longterm hospitalization has become an important political issue. The ALOS requirement for acute care hospitals was shortened by the Medical Care Payments Revision in April 2002. It is important to evaluate the influences of the Medical Care Payments Revision on ALOS and effects of medical treatment for considering future medical policies such as medical care payments.<br>In this paper, length of stay and effects of medical treatment were analyzed using the data of patients hospitalized due to transcervical fractures and for artificial head replacement or oseteosynthesis operations. The influences of the Medical Care Payments Revision in 2002 were evaluated, and factors which might influence the length of stay and medical treatment effects (walking ability at the time of ending hospitalization) were also analyzed. The length of stay was analyzed by the discrete-type proportional hazard model, and the effects of medical treatment were analyzed by the ordered probit models. The findings were: i) although the length of stay was not significantly shortened by the Medical Care Payments Revision in 2002, walking abilitiy became worse after the Revision, ii) cement usage at the operation, infections and complications were important factors affecting the length of stay, and iii) in addition to walking ability at the time of hospitalization, dementia, infections, complications, residential conditions and place of return were all important factors affecting the walking ability at the time of ending hospitalization.

Journal

  • Iryo To Shakai

    Iryo To Shakai 14 (4), 99-115, 2005

    The Health Care Science Institute

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