著者

Kenshi Hayashida Genki Murakami Shinya Matsuda Kiyohide Fushimi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.1, pp.1-11, 2021-01-05 (Released:2021-01-05)

参考文献数

32

被引用文献数

138

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DPC, which is an acronym for “Diagnosis Procedure Combination,” is a patient classification method developed in Japan for inpatients in the acute phase of illness. It was developed as a measuring tool intended to make acute inpatient care transparent, aiming at standardization of Japanese medical care, as well as evaluation and improvement of its quality. Subsequently, this classification method came to be used in the Japanese medical service reimbursement system for acute inpatient care and appropriate allocation of medical resources. Furthermore, it has recently contributed to the development and maintenance of an appropriate medical care provision system at a regional level, which is accomplished based on DPC data used for patient classification. In this paper, we first provide an overview of DPC. Next, we will look back at over 15 years of DPC history; in particular, we will explore how DPC has been refined to become an appropriate medical service reimbursement system. Finally, we will introduce an outline of DPC-related research, starting with research using DPC data.

著者

Yui Yamaoka Takeo Fujiwara Yoshihisa Fujino Shinya Matsuda Kiyohide Fushimi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20180094, (Released:2019-02-02)

参考文献数

34

被引用文献数

20

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Background: Abusive head trauma (AHT) is the leading cause of fatal maltreatment among young children. The incidence of AHT in Japan, however, remains unknown. This study examined the incidence and distribution of age in months among young children under 12 months old hospitalized with intracranial injury in Japan.Methods: We conducted multicenter cross-sectional study for children under 36 months old admitted with intracranial injury to hospitals that employed the Diagnostic Procedure Combination (DPC) payment system between 2010 and 2013. Presumptive and possible AHT were defined by the combination of ICD-10 codes modified from the coding system recommended by the US Centers for Disease Control and Prevention.Results: The average incidence was 7.2 (95% confidence interval [CI]: 7.18-7.26) for presumptive and 41.7 (95% CI: 41.7-41.8) for possible AHT per 100,000 children less than 12 months old from 2010 to 2013. The distributions of age in months for both presumptive AHT and possible AHT had peaks at around two and eight months.Conclusions: This is the first study to report the incidence of hospitalized children with presumptive and possible AHT using population-based data. Further datasets are needed to evaluate the incidence and specific preventive strategies to prevent AHT in infants during the months of highest risk.

著者

Tsutomu Odahara Masataka Irokawa Hiroshi Karasawa Shinya Matsuda

出版者

Japan Society for Occupational Health

雑誌

Journal of Occupational Health (ISSN:13419145)

巻号頁・発行日

vol.52, no.5, pp.278-286, 2010 (Released:2010-10-07)

参考文献数

33

被引用文献数

3 7

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Objective: To assess the usefulness of the Laboratory of Physical Science (LOPS) protocol for detecting exaggerated blood pressure (BP) response as a risk factor for future hypertension when controlling for work and personal factors. Methods: Subjects were 815 healthy normotensive men (mean age, 43.1 ± 6.76 yr; range, 29-64 yr) who participated in the LOPS protocol, a graded 4-stage exercise test undertaken for the measurement of 40-70% of maximum oxygen consumption. A hypertensive response was defined as systolic blood pressure (SBP) of 250 mmHg or diastolic blood pressure (DBP) of 120 mmHg during the exercise test. Results: New-onset hypertension or the initiation of antihypertensive drug treatment had occurred in 108 men (13.3%) after 7 yr of follow-up. Cox proportional survival analysis revealed significantly increased risks of developing hypertension were associated with exaggerated BP response to exercise (hazard ratio, 2.3; 95% confidence interval, 1.4-3.7) and higher frequency of business trips (hazard ratio, 1.7; 95% confidence interval, 1.2-2.5) after multivariable adjustments for work and personal-related risk factors. Conclusions: These results suggest that the LOPS protocol is effective for detecting exaggerated BP response as a risk factor for future hypertension when controlling for work and personal-related risk factors. Exaggerated BP response to exercise and higher frequency of business trips are risk factors for developing future hypertension.

著者

Koki Ibayashi Yoshihisa Fujino Masakazu Mimaki Kenji Fujimoto Shinya Matsuda Yu-ichi Goto

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.2, pp.68-75, 2023-02-05 (Released:2023-02-05)

参考文献数

33

被引用文献数

3

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Background: To provide a better healthcare system for patients with mitochondrial diseases, it is important to understand the basic epidemiology of these conditions, including the number of patients affected. However, little information about them has appeared in Japan to date.Methods: To gather data of patients with mitochondrial diseases, we estimated the number of patients with mitochondrial diseases from April 2018 through March 2019 using a national Japanese health care claims database, the National Database (NDB). Further, we calculated the prevalence of patients, and sex ratio, age class, and geographical distribution.Results: From April 2018 through March 2019, the number of patients with mitochondrial diseases was 3,629, and the prevalence was 2.9 (95% confidence interval [CI], 2.8–3.0) per 100,000 general population. The ratio of females and males was 53 to 47, and the most frequent age class was 40–49 years old. Tokyo had the greatest number of patients with mitochondrial diseases, at 477, whereas Yamanashi had the fewest, at 13. Kagoshima had the highest prevalence of patients with mitochondrial diseases, 8.4 (95% CI, 7.1–10.0) per 100,000 population, whereas Yamanashi had the lowest, 1.6 (95% CI, 0.8–2.7).Conclusion: The number of patients with mitochondrial diseases estimated by this study, 3,269, was more than double that indicated by the Japanese government. This result may imply that about half of all patients are overlooked for reasons such as low severity of illness, suggesting that the Japanese healthcare system needs to provide additional support for these patients.

著者

松田 愼也 Shinya Matsuda

出版者

上越教育大学

雑誌

上越教育大学研究紀要 (ISSN:09158162)

巻号頁・発行日

vol.19, no.2, pp.433-443, 2000-03

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律蔵における厠での作法,とりわけその浄化儀礼において,7世紀末,長期のインド留学から帰唐した義浄のもたらした根本説一切有部のそれは,極めて特異かつ複雑であり,5世紀前半に訳された他の漢訳諸律との相違が大きい。本稿は,その理由を探るため,諸律における厠の具体的な構造を明らかにし,そこで行われる作法の比較検討を試みた。

著者

Keiji Muramatsu Hanaka Imamura Kei Tokutsu Kenji Fujimoto Kiyohide Fushimi Shinya Matsuda

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.4, pp.163-167, 2022-04-05 (Released:2022-04-05)

参考文献数

25

被引用文献数

4 9

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Background: Food allergies are common among children, and food-induced anaphylaxis (FIA) is a serious disease with a risk of death; however, there is yet to be a large-scale epidemiological study on causative foods in Japan. The purpose of this study was to identify foods that cause FIA in Japan.Methods: We identified 9,079 patients from the Japanese Diagnosis Procedure Combination Database who were admitted for treatment for FIA from April 1, 2014 through March 31, 2017. We extracted data on patient sex, age, use of epinephrine injections on the first day, prescription for epinephrine self-injection on the day of discharge, length of stay, readmission, and causative foods.Results: The most common causative food was eggs, followed by wheat, milk, peanuts, and buckwheat. The most common causative food in each age group was eggs among 0–3-year-olds, milk among 4–6-year-olds, peanuts among 7–19-year-olds, and wheat among those aged 20 years and older. Epinephrine was used at admission among about 40%, 50%, and over 60% of cases in which the causative food was eggs; wheat, milk and peanuts; and buckwheat, respectively. The proportion of cases with a prescription for epinephrine self-injection at discharge was highest among those in which the causative food was wheat, followed by peanuts, buckwheat, milk, and eggs.Conclusions: FIA due to peanuts has become as common in Japan as it is in the West. These results suggest the importance of taking measures to prevent peanut allergies because children cannot make adequate decisions regarding food.

著者

Atsuhiko Murata Kohji Okamoto Toshihiko Mayumi Keiji Maramatsu Shinya Matsuda

出版者

Tohoku University Medical Press

雑誌

The Tohoku Journal of Experimental Medicine (ISSN:00408727)

巻号頁・発行日

vol.233, no.1, pp.9-15, 2014 (Released:2014-04-17)

参考文献数

21

被引用文献数

21 25

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Acute abdominal pain is one of the most frequent causes of admission to emergency departments. However, there is a shortage of detail information showing the difference of outcomes or etiology of acute abdominal pain according to age. We therefore conducted an epidemiological analysis to reveal the difference between age on outcomes and etiology of acute abdominal pain using an administrative database associated with the Diagnosis Procedure Combination (DPC) system. We obtained discharge data relating to 12,209 patients with acute abdominal pain from 931 DPC participation hospitals between 2009 and 2011 in Japan. We compared length of hospital stay (LOS), in-hospital mortality, and etiology of acute abdominal pain between age categories. Patients were divided into five age groups as follows: < 20 (n = 1,106), 20-39 (n = 3,353), 40-59 (n = 2,925), 60-79 (n = 3,144), and ≥ 80 years (n = 1,681). Longer LOS and higher in-hospital mortality were observed in patients aged ≥ 80 years (p < 0.001). Regarding etiologies of acute abdominal pain, intestinal infection or acute appendicitis were more frequent in patients aged < 20 or 20-39 years, while ileus or cholelithiasis were more frequent in patients aged 60-79 or ≥ 80 years in both male and female patients (p < 0.001). This study demonstrated the significant differences between age with regard to the patient outcomes and etiology of acute abdominal pain. The current findings highlight the importance of improving the quality of medical care for patients with acute abdominal pain.

著者

Shinya Matsuda Kenji Fujimori

出版者

Asian Pacific Society of Health Support Science

雑誌

Asian Pacific Journal of Disease Management (ISSN:18823130)

巻号頁・発行日

vol.6, no.3-4, pp.55-59, 2014 (Released:2015-06-27)

参考文献数

11

被引用文献数

13 23

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Based on the Fee-For-Service tariff system, Japan has developed the National Database (NDB) that registers all health care insurance claims. Compared with the similar databases of other countries, NDB has more detailed data, i.e., insurer’s code, insured ID number, diagnoses, age, sex, date of consultation for out-patient service, date of admission, date of discharge, procedures and drugs provided with information of date, volume and tariff. Annually more than 1,700 million records are registered into NDB. In this article, the authors will explain the detail of NDB and its future.

著者

Haruhisa Ibayashi Yoshihisa Fujino Truong-Minh Pham Shinya Matsuda

出版者

Tohoku University Medical Press

雑誌

The Tohoku Journal of Experimental Medicine (ISSN:00408727)

巻号頁・発行日

vol.215, no.3, pp.237-245, 2008 (Released:2008-07-19)

参考文献数

38

被引用文献数

33 45

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In Japan, one of the duties of the long-term care insurance system is the prevention of oral function degradation. Although various exercise programs for oral function have been developed and practiced in Japan, to date, no study has reported their effects. In the present study, we examined the effects of an exercise program on oral functions in healthy elderly people. Healthy elderly people participated in the study and were randomly divided into intervention and control groups (39 subjects/group). The exercise program consisted of four exercises: exercise for expression muscles, tongue, salivary glands, and swallowing. Before and after a six-month intervention period, we evaluated changes in oral functions, namely bite force, swallowing ability, and salivary flow rate. Fifty-four subjects completed the study protocol: 26 and 28 subjects from intervention and control groups, respectively. A significant improvement in all oral functions, including bite force, swallowing ability, as well as unstimulated and stimulated salivary flow rate, was observed in the intervention group after six months, whereas no improvement was observed in the control group. Further, among the intervention group, a significant improvement in oral functions was observed in 17 subjects with 20 or more remaining teeth, whereas no improvement was observed in the other nine with less than 20 teeth. Our results suggest that oral functions significantly improve after conducting a six-month exercise program for oral function. Further, this improvement appears to be influenced by the number of remaining teeth.

著者

Keiji MURAMATSU Yoshihisa FUJINO Tatsuhiko KUBO Makoto OTANI Shinya MATSUDA

出版者

National Institute of Occupational Safety and Health

雑誌

Industrial Health (ISSN:00198366)

巻号頁・発行日

vol.57, no.1, pp.79-83, 2019 (Released:2019-02-05)

参考文献数

17

被引用文献数

7

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This study used health insurance claims data to examine the relationship between the length of sick leave and treatment administered to employees who received middle- to long-term accident and sickness benefits for ≥91 d due to mood disorders, anxiety, and dissociative, stress-related, somatoform and other nonpsychotic mental disorders. Employees who received psychotherapy had significantly shorter leaves of absence over one year compared to those that did not. Treatment with psychotropic drugs was significantly higher among those on leave for ≤365 d than those on leave for ≥366 d. Age, sex and hospital treatment were not significantly associated with length of sick leave. These results suggest that professional psychological treatment is associated with length of sick leave.

著者

Shinya Matsuda

出版者

日本ヘルスサポート学会

雑誌

Asian Pacific Journal of Disease Management (ISSN:18823130)

巻号頁・発行日

vol.3, no.1, pp.1-9, 2009 (Released:2010-06-16)

参考文献数

7

被引用文献数

4

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In order to respond the expanding needs of health and ADL care for the aged, the Japanese government has implemented a series of health and social programs for the aged. The author thinks that the political populism is the most important cause of current difficulty of re-organizing the Japanese health system. For example, the introduction of free medical program for the aged in 1972 was decided as a result of political rivalry between the Ruling party and the left-wing Opposition parties. This program made our system too much medicalized and caused a rapid expansion of medical expenditures. The Long-term care insurance scheme (LTCI) was introduced in 2000 in order to de-medicalize the system by expanding home care capacity, but has not reduced medical expenditures as estimated before. In order to re-organize the system for the aged, the new scheme of health insurance for the aged has been introduced in 2008. However, just before the introduction of the new health insurance scheme, there started very strong opposition against the introduction of new scheme. Mass media launched a tremendous volume of negative campaigns and the Opposition parties has been criticizing the responsibility of government and Ruling parties. The two main points of critics are ageism and heavy financial burden for the aged, especially for those of lower economic status. According to the author's perspective, the most important cause of mistake for the introduction of new scheme is insufficient consideration for QOL and clinical outcomes. The debate has too much focused on cost sharing and financial burden. The philosophy of social security policy must be QOL issue, not financial control. The well organized health insurance scheme for the aged must be one of basic infrastructures in order to construct an active aged society. More creative debate is necessary.