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Development and analysis of a nationwide cost database of acute‐care hospitals in Japan
Author(s) -
Hayashida Kenshi,
Imanaka Yuichi,
Otsubo Tetsuya,
Kuwabara Kazuaki,
Ishikawa Kohicih B,
Fushimi Kiyohide,
Hashimoto Hideki,
Yasunaga Hideo,
Horiguchi Hiromasa,
Anan Makoto,
Fujimori Kenji,
Ikeda Shunya,
Matsuda Shinya
Publication year - 2009
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2008.01063.x
Subject(s) - activity based costing , database , cost database , payment , acute care , scale (ratio) , medicine , operations management , medical emergency , computer science , health care , business , accounting , finance , physics , quantum mechanics , economics , economic growth
Objectives Understanding of hospital cost is crucial to achieve an ideal balance between the assurance and improvement of patient safety and quality, and efficient use of finite resources. However, neither a standardized calculation methodology nor a large‐scale database of costs in acute‐care hospitals exists in Japan. This study aims to develop a standardized methodology, construct a nationwide cost database in Japan, analyse the characteristics of the database and examine the relationship between the cost and the charge from the viewpoint of an appropriate reflection of the cost to the price. Method We designed the costing framework, gathered the data for patients discharged from 139 acute‐care hospitals in Japan between July 2004 and October 2004 and constructed a database containing information on 284 730 patients. The characteristics of the database and the relationship between the cost and the charge were investigated. Results In the nationwide database we constructed, a wide range in the average cost per hospitalization and average cost per diem was observed. A wide variation of cost components was seen across major diagnostic categories. Moreover, there was a high correlation between the cost and the charge (Correlation coefficient = 0.94). Conclusions After designing a costing framework, a nationwide database comprised of individual case‐level costs with components for acute‐care hospitals in Japan was successfully developed. We hope this study contributes to appropriate decision making and helps motivate further research geared towards efficient hospital management and a rational payment system in Japan.