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Prefectural difference in spontaneous intracerebral hemorrhage incidence in Japan analyzed with publically accessible diagnosis procedure combination data: possibilities and limitations

View Article: PubMed Central - PubMed

ABSTRACT

Objectives:: Annually reported, publically accessible Diagnosis Procedure Combination (DPC) data from the Japanese government is a part of the total DPC database of the Japanese medical reimbursement system for hospitalization. Although medical issues can be evaluated with these data promptly, the applicability of these data in epidemiological analyses has not been assessed.

Methods:: We performed analyses using only statistical indices reported on the a government website. As a preliminary step, the prefectural consistency of spontaneous intracerebral hemorrhage (sICH) was examined with prefectural mortality over 20 years. Then the prefectural incidence of sICH for four years was calculated, utilizing publically accessible DPC data. To determine its reliability, the consistency was examined, and correlations were analyzed with three prefectural factors expected to have an effect: the elderly rate, mortality due to sICH, and the non-DPC bed rate. In addition, a comparison model between prefectures with this method was developed by analyzing other prefecture-specific factors.

Results:: Prefectural mortality due to sICH and prefectural sICH incidence in the DPC database were both consistent over the years. Prefectural sICH incidence had a constant positive correlation with the elderly rate, a partial correlation with mortality due to sICH, but no correlation with the non-DPC bed rate, which is one of the major biases when utilizing the DPC database. In the comparison model, the factors of low income and alcohol consumption showed increased sICH incidence.

Conclusions:: Although careful attention to its limitations is required, publically accessible DPC data will provide insights into epidemiological issues.

No MeSH data available.


Related in: MedlinePlus

Scattergrams indicating the relationship with prefectural sICH incidence in the DPC database in 2014. (A) The rate of the elderly aged 75 and over among prefectures varied from 0.099 to 0.180, and positive correlations were observed in both univariate and multivariate analyses. (B) The crude mortality due to sICH among prefectures varied from 18.5 to 49.7, and positive but insignificant correlation was observed. (C) The rate of non-DPC beds among prefectures varied from 0.23 to 0.49, and negative but insignificant correlation was observed. sICH, spontaneous intracerebral hemorrhage; DPC, Diagnosis Procedure Combination.
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f2-epih-38-e2016028: Scattergrams indicating the relationship with prefectural sICH incidence in the DPC database in 2014. (A) The rate of the elderly aged 75 and over among prefectures varied from 0.099 to 0.180, and positive correlations were observed in both univariate and multivariate analyses. (B) The crude mortality due to sICH among prefectures varied from 18.5 to 49.7, and positive but insignificant correlation was observed. (C) The rate of non-DPC beds among prefectures varied from 0.23 to 0.49, and negative but insignificant correlation was observed. sICH, spontaneous intracerebral hemorrhage; DPC, Diagnosis Procedure Combination.

Mentions: Table 2 indicates the Spearman’s correlation coefficient of three examined factors in each year, and Figure 2 indicates the relations between sICH incidence and these factors in 2014. Among examined factors, only the rate of the elderly aged 75 and over showed a significant positive correlation continuously for these four years. The crude mortality due to sICH showed positive correlation and the rate of non-DPC beds showed negative correlation, but they were non-significant. With a multiple regression analysis, no factor significantly affected the prefectural sICH in the DPC database in 2011 and in 2012; however, in 2013, the crude mortality due to sICH had a significant correlation (β=0.37, p=0.01), and in 2014, the rate of elderly persons had a significant correlation (β=0.30, p<0.05). All data from the three examined factors are shown in Appendices 4-6.


Prefectural difference in spontaneous intracerebral hemorrhage incidence in Japan analyzed with publically accessible diagnosis procedure combination data: possibilities and limitations
Scattergrams indicating the relationship with prefectural sICH incidence in the DPC database in 2014. (A) The rate of the elderly aged 75 and over among prefectures varied from 0.099 to 0.180, and positive correlations were observed in both univariate and multivariate analyses. (B) The crude mortality due to sICH among prefectures varied from 18.5 to 49.7, and positive but insignificant correlation was observed. (C) The rate of non-DPC beds among prefectures varied from 0.23 to 0.49, and negative but insignificant correlation was observed. sICH, spontaneous intracerebral hemorrhage; DPC, Diagnosis Procedure Combination.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037357&req=5

f2-epih-38-e2016028: Scattergrams indicating the relationship with prefectural sICH incidence in the DPC database in 2014. (A) The rate of the elderly aged 75 and over among prefectures varied from 0.099 to 0.180, and positive correlations were observed in both univariate and multivariate analyses. (B) The crude mortality due to sICH among prefectures varied from 18.5 to 49.7, and positive but insignificant correlation was observed. (C) The rate of non-DPC beds among prefectures varied from 0.23 to 0.49, and negative but insignificant correlation was observed. sICH, spontaneous intracerebral hemorrhage; DPC, Diagnosis Procedure Combination.
Mentions: Table 2 indicates the Spearman’s correlation coefficient of three examined factors in each year, and Figure 2 indicates the relations between sICH incidence and these factors in 2014. Among examined factors, only the rate of the elderly aged 75 and over showed a significant positive correlation continuously for these four years. The crude mortality due to sICH showed positive correlation and the rate of non-DPC beds showed negative correlation, but they were non-significant. With a multiple regression analysis, no factor significantly affected the prefectural sICH in the DPC database in 2011 and in 2012; however, in 2013, the crude mortality due to sICH had a significant correlation (β=0.37, p=0.01), and in 2014, the rate of elderly persons had a significant correlation (β=0.30, p<0.05). All data from the three examined factors are shown in Appendices 4-6.

View Article: PubMed Central - PubMed

ABSTRACT

Objectives:: Annually reported, publically accessible Diagnosis Procedure Combination (DPC) data from the Japanese government is a part of the total DPC database of the Japanese medical reimbursement system for hospitalization. Although medical issues can be evaluated with these data promptly, the applicability of these data in epidemiological analyses has not been assessed.

Methods:: We performed analyses using only statistical indices reported on the a government website. As a preliminary step, the prefectural consistency of spontaneous intracerebral hemorrhage (sICH) was examined with prefectural mortality over 20 years. Then the prefectural incidence of sICH for four years was calculated, utilizing publically accessible DPC data. To determine its reliability, the consistency was examined, and correlations were analyzed with three prefectural factors expected to have an effect: the elderly rate, mortality due to sICH, and the non-DPC bed rate. In addition, a comparison model between prefectures with this method was developed by analyzing other prefecture-specific factors.

Results:: Prefectural mortality due to sICH and prefectural sICH incidence in the DPC database were both consistent over the years. Prefectural sICH incidence had a constant positive correlation with the elderly rate, a partial correlation with mortality due to sICH, but no correlation with the non-DPC bed rate, which is one of the major biases when utilizing the DPC database. In the comparison model, the factors of low income and alcohol consumption showed increased sICH incidence.

Conclusions:: Although careful attention to its limitations is required, publically accessible DPC data will provide insights into epidemiological issues.

No MeSH data available.


Related in: MedlinePlus