Multi-institutional analysis on cost and quality of health care for data-based strategic improvement

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The clinical and financial database of the discharged patients were established and analyzed in this study. For the cost-analysis part of this study, a standardized costing methodology with reliable cost database in health care had not been established although it was increasingly important to assess standardized hospital cost information. Based on a standardized costing methodology we developed, we analyzed the characteristics of the healthcare cost, and we conducted a national questionnaire survey of the teaching hospitals in Japan. We evaluated the costs of the systems for patient safety focused on staff assignment, meetings and conferences, internal audit, staff education and training, incident reporting, infection surveillance, infectious disposal, management of medication use, clinical engineering, and patient counseling. The determinants if the volume of safety activities were also investigated. Our results showed that hospital-wide activities for patient safety posed significan … More t costs to hospitals and national healthcare systems.For the objective assessment of healthcare quality and performance, we developed new and valid risk-adjustment methods to evaluate in-hospital acute care based on a set of data readily available in the standardized discharge data including age, gender, primary diagnosis, and coded comorbidity. To make the best use of diagnostic information, we used new strategies by use of detailed disease coding information and set classification of comorbidity. Our models were very important in handling the available data well for the risk-adjustment of mortality in specific diseases such as AMI and could offer a new approach to evaluate clinical performance at the hospital level. In addition, we analyzed the use of resources and the patterns of health care practice which would reflect some aspects of the quality and the efficiency of health care. The variation in practice was analyzed and expressed in valid and useful forms, and fedback to hospitals and professionals for further improvement of practice based on the results of scientific and objective assessment we developed. Less