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An Observational Study Using a National Administrative Database to Determine the Impact of Hospital Volume on Compliance With Clinical Practice Guidelines

Bibliographic Data

ID9098724
AuthorsAtsuhiko Murata (University of Occupational and Environmental Health Japan, corresponding author), Sandy Matsuda (0000-0002-8472-8909, University of Occupational and Environmental Health Japan, corresponding author), Shinya Matsuda (0000-0002-7541-7914), Kazuaki Kuwabara (Kyushu University), Yoshihisa Fujino (0000-0002-9126-206X, University of Occupational and Environmental Health Japan, corresponding author), Tatsuhiko Kubo (0000-0001-8822-9181, University of Occupational and Environmental Health Japan, corresponding author), Kenji Fujimori (0000-0003-2199-7172, Hokkaido University), Hiromasa Horiguchi (0000-0002-4921-7652, University of Tokyo Health Sciences)
Year2011
Volume49
Issue3
Pages313-320
Publication date2011-03-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3182028954
PMID21263358
OpenAlexW2033211217
LanguageEN
References cited37

BACKGROUND: Little information is available on the relationship between hospital volume and compliance with clinical practice guidelines (CPGs). OBJECTIVES: To investigate the relationship between hospital volume and compliance with CPGs using a Japanese administrative database. DESIGN AND SUBJECTS: This was an observational study that included 60,842 patients with acute cholangitis from 829 hospitals in Japan. MEASURES: Hospital volume was categorized into the following 3 groups based on the number of cases of acute cholangitis during the study period: low-volume hospitals (LVHs; n = 20,869), medium-volume hospitals (MVHs; n = 18,387), and high-volume hospitals (HVHs; n = 21,586). We further collected patient data with regard to CPGs for acute cholangitis, and counted the number of recommendations that had been complied with for each patient. CPGs compliance score was defined as the rate of compliance with these recommendations for each patient (range, 0-10). Aggregated CPGs compliance score was measured according to hospital volume. RESULTS: Mean CPGs compliance score in HVHs was significantly higher than that in MVHs and LVHs (6.8 ± 1.6 vs. 5.6 ± 1.5 vs. 3.9 ± 1.4, respectively; P < 0.001). Multiple linear regression analysis revealed that hospital volume was most significantly associated with CPGs compliance score. The standardized coefficient for CPGs compliance score in HVHs was 0.689, whereas that of MVHs was 0.366 (P < 0.001). CONCLUSIONS: This study demonstrated that hospital volume was significantly associated with compliance with CPGs and that the Japanese administrative database was a viable tool for the monitoring of compliance with CPGs

Compliance (psychology) · Database · Intensive care medicine · Medical emergency · Observational study · Volume (thermodynamics) · Clinical practice guidelines implementation · Computer Science · Emergency Medicine · Gallbladder and Bile Duct Disorders · Health Policy Implementation Science · Internal Medicine · Medicine · Psychology

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    John D Birkmeyer, Andrea E Siewers et al.•New England Journal of Medicine•2002

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    Open Access•Mary E Charlson, Peter Pompei et al.•Journal of Chronic Diseases•1987

  • Coding Algorithms for Defining Comorbidities in ICD-9-CM and ICD-10 Administrative Data

    Hude Quan, Vijaya Sundararajan et al.•Medical Care•2005

Citation velocityhistorical
Highly citedNo

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