The Potential of a Stroke Registry Using Diagnosis Procedure Combination Data from All Hospitals in a Japanese Prefecture
The Potential of a Stroke Registry Using Diagnosis Procedure Combination Data from All Hospitals in a Japanese Prefecture
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DOI：
10.1159/000520668
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发表时间：
2022-01-26
影响因子：
2.9
通讯作者：
Sakata, Kiyomi
中科院分区：
文献类型：
--
作者：
Omama, Shinichi;Tanno, Kozo;Sakata, Kiyomi
目的：在日本，许多医院已经加入了诊断程序组合/每日支付系统（DPC/PDPS），提供统一的住院患者信息。DPC数据已数字化，参与医院的数量最近有所增加。在此，我们评估了使用来自日本岩手县所有医院的统一DPC数据构建卒中登记的潜力。方法：计算dpc参与医院登记的脑血管病（CVD）病例的比例，并将其与2008-2017年岩手卒中登记所登记的所有病例进行比较。这些病例根据性别、年龄组、脑卒中亚型、首次发病或复发发病进行分类。以脑卒中登记病例为基础，对典型核心医院和典型非核心医院的DPC数据进行疾病名称提取CVD病例的准确性评价。结果：2018年岩手县71家医院9992张床位中，有50家医院8316张床位参与了DPC系统。所有卒中类型（男性95.6%，女性94.9%）在参与医院登记的病例比例为95.2%(44,779/47,018)，脑梗死94.3%，脑出血97.0%，蛛网膜下腔出血98.7%，而首次发病为95.7%，复发为94.1%。登记病例比例随患者年龄的增加而下降。主治医生和研究人员分别从核心医院和非核心医院登记了486例和41例CVD病例，从这些医院的DPC数据中分别提取了455例和46例CVD病例。核心医院的敏感性为86.6%，特异性为99.3%，阳性预测值为92.5%，阴性预测值为98.7%；这些数值在非核心医院分别为92.7%、98.6%、82.6%和99.5%。讨论/结论：使用岩手县所有医院的DPC数据构建的卒中登记似乎足够完整和准确。
Objectives: In Japan, many hospitals have joined the diagnosis procedure combination/per-diem payment system (DPC/PDPS), which provides unified information about inpatients. DPC data are digitized, and the number of participating hospitals has increased recently. Herein, we evaluated the potential of a stroke registry constructed using these unified DPC data from all hospitals in the Iwate Prefecture, Japan. Methods: The proportion of cerebrovascular disease (CVD) cases registered by DPC-participating hospitals was calculated and compared with all registered cases in the Iwate Stroke Registry in 2008-2017. The cases were categorized based on sex, age-groups, stroke subtypes, and first-ever onset or recurrence onset. Based on the registered cases in the stroke registry, the accuracy of the CVD cases extracted by the disease name from DPC data of a typical core hospital and a typical noncore hospital was evaluated. Results: Of the 71 hospitals with 9,992 beds in the Iwate Prefecture in 2018, 50 hospitals with 8,316 beds participated in the DPC system. The proportion of registered cases from participating hospitals was 95.2% (44,779/47,018) for all stroke types (95.6% men and 94.9% women), 94.3% for cerebral infarction, 97.0% for intracerebral hemorrhage, and 98.7% for subarachnoid hemorrhage, whereas it was 95.7% for first-ever onset and 94.1% for recurrent onset. The proportion of registered cases decreased with increasing patient age. Attending doctors and researchers registered 486 and 41 CVD cases from the core and noncore hospitals, respectively, whereas 455 and 46 CVD cases were extracted from the DPC data of these hospitals, respectively. This yielded 86.6% sensitivity, 99.3% specificity, 92.5% positive predictive value, and 98.7% negative predictive value for the core hospital; these values were 92.7%, 98.6%, 82.6%, and 99.5%, respectively, for the noncore hospital. Discussion/Conclusions: The stroke registry constructed using DPC data from all hospitals of Iwate Prefecture appears to be adequately complete and accurate.