Impact of Hospital Practice Factors on Mortality in Patients Hospitalized for Heart Failure in Japan ― An Analysis of a Large Number of Health Records From a Nationwide Claims-Based Database, the JROAD-DPC
Background:An inverse relationship exists between hospital case volume and mortality in patients with heart failure (HF). However, hospital performance factors associated with mortality in HF patients have not been examined. We aimed to identify these using exploratory factor analysis and assess the...
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| Veröffentlicht in: | Circulation Journal 2020/04/24, Vol.84(5), pp.742-753 |
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| creator | Kaku, Hidetaka Funakoshi, Kouta Ide, Tomomi Fujino, Takeo Matsushima, Shouji Ohtani, Kisho Higo, Taiki Nakai, Michikazu Sumita, Yoko Nishimura, Kunihiro Miyamoto, Yoshihiro Anzai, Toshihisa Tsutsui, Hiroyuki |
| description | Background:An inverse relationship exists between hospital case volume and mortality in patients with heart failure (HF). However, hospital performance factors associated with mortality in HF patients have not been examined. We aimed to identify these using exploratory factor analysis and assess the relationship between these factors and 7-day, 30-day, and in-hospital mortality among HF patients in Japan.Methods and Results:We analyzed the records of 198,861 patients admitted to 683 certified hospitals of the Japanese Circulation Society between 2012 and 2014. Records were obtained from the nationwide database of the Japanese Registry Of All cardiac and vascular Diseases-Diagnostic Procedure Combination (JROAD-DPC). Using exploratory factor analysis, 90 hospital survey items were grouped into 5 factors, according to their collinearity: “Interventional cardiology”, “Cardiovascular surgery”, “Pediatric cardiology”, “Electrophysiology” and “Cardiac rehabilitation”. Multivariable logistic regression analysis was performed to determine the association between these factors and mortality. The 30-day mortality was 8.0%. Multivariable logistic regression analysis showed the “Pediatric cardiology” (odds ratio (OR) 0.677, 95% confidence interval [CI]: 0.628–0.729, P |
| doi_str_mv | 10.1253/circj.CJ-19-0759 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2385706064</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2385706064</sourcerecordid><originalsourceid>FETCH-LOGICAL-c677t-7dcde65aa336ef766cab53174fa779436531670c1dc28b57bb5473f37b85952a3</originalsourceid><addsrcrecordid>eNpFUc2O0zAQjhCIXQp3TshHDmRx4jhOjiWldKuyW63gbE2cydZVEndtV6ic9iV4MF4BXgT3h65kecb292PNF0VvE3qVpJx9VNqq9VU1j5MypoKXz6LLhGUizoqUPj_0eVwWGbuIXjm3pjQtKS9fRhcsTVmRZ-wy-n3db0B5YloyM26jPXRkacONVkimoRrriBnIV2PDk_Y7ogeyBK9x8O5M0T-xIa2xZIZgfeDpbmtxD53DBoa_j49_Hn-R8RAWdDun3d4PyALsPZKbbV-jPfwAofMrcofK2MaRqTV9QN0ENzP80A2SqgPdu_gTuOA3AQ916D4Qv0Iyv7sdT-LJsnodvWihc_jmVEfR9-nnb9UsXtx-ua7Gi1jlQvhYNKrBnAMwlmMr8lxBzVkishaEKDOWh0MuqEoalRY1F3XNM8FaJuqClzwFNoreH3U31jxs0XnZa6ew62BAs3UyTJgLmtMw5lFEj1BljXMWW7mxuge7kwmV-yDlIUhZzWVSyn2QgfLupL6te2zOhP_JBcD0CFg7D_d4BoT5a9XhSbHIJN9vT8pPgBVYiQP7B4-PtpQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2385706064</pqid></control><display><type>article</type><title>Impact of Hospital Practice Factors on Mortality in Patients Hospitalized for Heart Failure in Japan ― An Analysis of a Large Number of Health Records From a Nationwide Claims-Based Database, the JROAD-DPC</title><source>J-STAGE Free</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Kaku, Hidetaka ; Funakoshi, Kouta ; Ide, Tomomi ; Fujino, Takeo ; Matsushima, Shouji ; Ohtani, Kisho ; Higo, Taiki ; Nakai, Michikazu ; Sumita, Yoko ; Nishimura, Kunihiro ; Miyamoto, Yoshihiro ; Anzai, Toshihisa ; Tsutsui, Hiroyuki</creator><creatorcontrib>Kaku, Hidetaka ; Funakoshi, Kouta ; Ide, Tomomi ; Fujino, Takeo ; Matsushima, Shouji ; Ohtani, Kisho ; Higo, Taiki ; Nakai, Michikazu ; Sumita, Yoko ; Nishimura, Kunihiro ; Miyamoto, Yoshihiro ; Anzai, Toshihisa ; Tsutsui, Hiroyuki</creatorcontrib><description>Background:An inverse relationship exists between hospital case volume and mortality in patients with heart failure (HF). However, hospital performance factors associated with mortality in HF patients have not been examined. We aimed to identify these using exploratory factor analysis and assess the relationship between these factors and 7-day, 30-day, and in-hospital mortality among HF patients in Japan.Methods and Results:We analyzed the records of 198,861 patients admitted to 683 certified hospitals of the Japanese Circulation Society between 2012 and 2014. Records were obtained from the nationwide database of the Japanese Registry Of All cardiac and vascular Diseases-Diagnostic Procedure Combination (JROAD-DPC). Using exploratory factor analysis, 90 hospital survey items were grouped into 5 factors, according to their collinearity: “Interventional cardiology”, “Cardiovascular surgery”, “Pediatric cardiology”, “Electrophysiology” and “Cardiac rehabilitation”. Multivariable logistic regression analysis was performed to determine the association between these factors and mortality. The 30-day mortality was 8.0%. Multivariable logistic regression analysis showed the “Pediatric cardiology” (odds ratio (OR) 0.677, 95% confidence interval [CI]: 0.628–0.729, P<0.0001), “Electrophysiology” (OR 0.876, 95% CI: 0.832–0.923, P<0.0001), and “Cardiac rehabilitation” (OR 0.832, 95% CI: 0.792–0.873, P<0.0001) factors were associated with lower mortality. In contrast, “Interventional cardiology” (OR 1.167, 95% CI: 1.070–1.272, P<0.0001) was associated with higher mortality.Conclusions:Hospital factors, including various cardiovascular therapeutic practices, may be associated with the early death of HF patients.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-19-0759</identifier><identifier>PMID: 32238643</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Administrative Claims, Healthcare ; Aged ; Aged, 80 and over ; Cardiac rehabilitation ; Cluster Analysis ; Databases, Factual ; Electrophysiology ; Exploratory factor analysis ; Factor Analysis, Statistical ; Female ; Heart failure ; Heart Failure - diagnosis ; Heart Failure - mortality ; Heart Failure - therapy ; Hospital Mortality ; Hospitalization ; Humans ; Japan - epidemiology ; Male ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome</subject><ispartof>Circulation Journal, 2020/04/24, Vol.84(5), pp.742-753</ispartof><rights>2020 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c677t-7dcde65aa336ef766cab53174fa779436531670c1dc28b57bb5473f37b85952a3</citedby><cites>FETCH-LOGICAL-c677t-7dcde65aa336ef766cab53174fa779436531670c1dc28b57bb5473f37b85952a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32238643$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kaku, Hidetaka</creatorcontrib><creatorcontrib>Funakoshi, Kouta</creatorcontrib><creatorcontrib>Ide, Tomomi</creatorcontrib><creatorcontrib>Fujino, Takeo</creatorcontrib><creatorcontrib>Matsushima, Shouji</creatorcontrib><creatorcontrib>Ohtani, Kisho</creatorcontrib><creatorcontrib>Higo, Taiki</creatorcontrib><creatorcontrib>Nakai, Michikazu</creatorcontrib><creatorcontrib>Sumita, Yoko</creatorcontrib><creatorcontrib>Nishimura, Kunihiro</creatorcontrib><creatorcontrib>Miyamoto, Yoshihiro</creatorcontrib><creatorcontrib>Anzai, Toshihisa</creatorcontrib><creatorcontrib>Tsutsui, Hiroyuki</creatorcontrib><title>Impact of Hospital Practice Factors on Mortality in Patients Hospitalized for Heart Failure in Japan ― An Analysis of a Large Number of Health Records From a Nationwide Claims-Based Database, the JROAD-DPC</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background:An inverse relationship exists between hospital case volume and mortality in patients with heart failure (HF). However, hospital performance factors associated with mortality in HF patients have not been examined. We aimed to identify these using exploratory factor analysis and assess the relationship between these factors and 7-day, 30-day, and in-hospital mortality among HF patients in Japan.Methods and Results:We analyzed the records of 198,861 patients admitted to 683 certified hospitals of the Japanese Circulation Society between 2012 and 2014. Records were obtained from the nationwide database of the Japanese Registry Of All cardiac and vascular Diseases-Diagnostic Procedure Combination (JROAD-DPC). Using exploratory factor analysis, 90 hospital survey items were grouped into 5 factors, according to their collinearity: “Interventional cardiology”, “Cardiovascular surgery”, “Pediatric cardiology”, “Electrophysiology” and “Cardiac rehabilitation”. Multivariable logistic regression analysis was performed to determine the association between these factors and mortality. The 30-day mortality was 8.0%. Multivariable logistic regression analysis showed the “Pediatric cardiology” (odds ratio (OR) 0.677, 95% confidence interval [CI]: 0.628–0.729, P<0.0001), “Electrophysiology” (OR 0.876, 95% CI: 0.832–0.923, P<0.0001), and “Cardiac rehabilitation” (OR 0.832, 95% CI: 0.792–0.873, P<0.0001) factors were associated with lower mortality. In contrast, “Interventional cardiology” (OR 1.167, 95% CI: 1.070–1.272, P<0.0001) was associated with higher mortality.Conclusions:Hospital factors, including various cardiovascular therapeutic practices, may be associated with the early death of HF patients.</description><subject>Administrative Claims, Healthcare</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiac rehabilitation</subject><subject>Cluster Analysis</subject><subject>Databases, Factual</subject><subject>Electrophysiology</subject><subject>Exploratory factor analysis</subject><subject>Factor Analysis, Statistical</subject><subject>Female</subject><subject>Heart failure</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - therapy</subject><subject>Hospital Mortality</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1346-9843</issn><issn>1347-4820</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFUc2O0zAQjhCIXQp3TshHDmRx4jhOjiWldKuyW63gbE2cydZVEndtV6ic9iV4MF4BXgT3h65kecb292PNF0VvE3qVpJx9VNqq9VU1j5MypoKXz6LLhGUizoqUPj_0eVwWGbuIXjm3pjQtKS9fRhcsTVmRZ-wy-n3db0B5YloyM26jPXRkacONVkimoRrriBnIV2PDk_Y7ogeyBK9x8O5M0T-xIa2xZIZgfeDpbmtxD53DBoa_j49_Hn-R8RAWdDun3d4PyALsPZKbbV-jPfwAofMrcofK2MaRqTV9QN0ENzP80A2SqgPdu_gTuOA3AQ916D4Qv0Iyv7sdT-LJsnodvWihc_jmVEfR9-nnb9UsXtx-ua7Gi1jlQvhYNKrBnAMwlmMr8lxBzVkishaEKDOWh0MuqEoalRY1F3XNM8FaJuqClzwFNoreH3U31jxs0XnZa6ew62BAs3UyTJgLmtMw5lFEj1BljXMWW7mxuge7kwmV-yDlIUhZzWVSyn2QgfLupL6te2zOhP_JBcD0CFg7D_d4BoT5a9XhSbHIJN9vT8pPgBVYiQP7B4-PtpQ</recordid><startdate>20200424</startdate><enddate>20200424</enddate><creator>Kaku, Hidetaka</creator><creator>Funakoshi, Kouta</creator><creator>Ide, Tomomi</creator><creator>Fujino, Takeo</creator><creator>Matsushima, Shouji</creator><creator>Ohtani, Kisho</creator><creator>Higo, Taiki</creator><creator>Nakai, Michikazu</creator><creator>Sumita, Yoko</creator><creator>Nishimura, Kunihiro</creator><creator>Miyamoto, Yoshihiro</creator><creator>Anzai, Toshihisa</creator><creator>Tsutsui, Hiroyuki</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200424</creationdate><title>Impact of Hospital Practice Factors on Mortality in Patients Hospitalized for Heart Failure in Japan ― An Analysis of a Large Number of Health Records From a Nationwide Claims-Based Database, the JROAD-DPC</title><author>Kaku, Hidetaka ; Funakoshi, Kouta ; Ide, Tomomi ; Fujino, Takeo ; Matsushima, Shouji ; Ohtani, Kisho ; Higo, Taiki ; Nakai, Michikazu ; Sumita, Yoko ; Nishimura, Kunihiro ; Miyamoto, Yoshihiro ; Anzai, Toshihisa ; Tsutsui, Hiroyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c677t-7dcde65aa336ef766cab53174fa779436531670c1dc28b57bb5473f37b85952a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Administrative Claims, Healthcare</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiac rehabilitation</topic><topic>Cluster Analysis</topic><topic>Databases, Factual</topic><topic>Electrophysiology</topic><topic>Exploratory factor analysis</topic><topic>Factor Analysis, Statistical</topic><topic>Female</topic><topic>Heart failure</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - therapy</topic><topic>Hospital Mortality</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kaku, Hidetaka</creatorcontrib><creatorcontrib>Funakoshi, Kouta</creatorcontrib><creatorcontrib>Ide, Tomomi</creatorcontrib><creatorcontrib>Fujino, Takeo</creatorcontrib><creatorcontrib>Matsushima, Shouji</creatorcontrib><creatorcontrib>Ohtani, Kisho</creatorcontrib><creatorcontrib>Higo, Taiki</creatorcontrib><creatorcontrib>Nakai, Michikazu</creatorcontrib><creatorcontrib>Sumita, Yoko</creatorcontrib><creatorcontrib>Nishimura, Kunihiro</creatorcontrib><creatorcontrib>Miyamoto, Yoshihiro</creatorcontrib><creatorcontrib>Anzai, Toshihisa</creatorcontrib><creatorcontrib>Tsutsui, Hiroyuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kaku, Hidetaka</au><au>Funakoshi, Kouta</au><au>Ide, Tomomi</au><au>Fujino, Takeo</au><au>Matsushima, Shouji</au><au>Ohtani, Kisho</au><au>Higo, Taiki</au><au>Nakai, Michikazu</au><au>Sumita, Yoko</au><au>Nishimura, Kunihiro</au><au>Miyamoto, Yoshihiro</au><au>Anzai, Toshihisa</au><au>Tsutsui, Hiroyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Hospital Practice Factors on Mortality in Patients Hospitalized for Heart Failure in Japan ― An Analysis of a Large Number of Health Records From a Nationwide Claims-Based Database, the JROAD-DPC</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2020-04-24</date><risdate>2020</risdate><volume>84</volume><issue>5</issue><spage>742</spage><epage>753</epage><pages>742-753</pages><issn>1346-9843</issn><issn>1347-4820</issn><eissn>1347-4820</eissn><abstract>Background:An inverse relationship exists between hospital case volume and mortality in patients with heart failure (HF). However, hospital performance factors associated with mortality in HF patients have not been examined. We aimed to identify these using exploratory factor analysis and assess the relationship between these factors and 7-day, 30-day, and in-hospital mortality among HF patients in Japan.Methods and Results:We analyzed the records of 198,861 patients admitted to 683 certified hospitals of the Japanese Circulation Society between 2012 and 2014. Records were obtained from the nationwide database of the Japanese Registry Of All cardiac and vascular Diseases-Diagnostic Procedure Combination (JROAD-DPC). Using exploratory factor analysis, 90 hospital survey items were grouped into 5 factors, according to their collinearity: “Interventional cardiology”, “Cardiovascular surgery”, “Pediatric cardiology”, “Electrophysiology” and “Cardiac rehabilitation”. Multivariable logistic regression analysis was performed to determine the association between these factors and mortality. The 30-day mortality was 8.0%. Multivariable logistic regression analysis showed the “Pediatric cardiology” (odds ratio (OR) 0.677, 95% confidence interval [CI]: 0.628–0.729, P<0.0001), “Electrophysiology” (OR 0.876, 95% CI: 0.832–0.923, P<0.0001), and “Cardiac rehabilitation” (OR 0.832, 95% CI: 0.792–0.873, P<0.0001) factors were associated with lower mortality. In contrast, “Interventional cardiology” (OR 1.167, 95% CI: 1.070–1.272, P<0.0001) was associated with higher mortality.Conclusions:Hospital factors, including various cardiovascular therapeutic practices, may be associated with the early death of HF patients.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>32238643</pmid><doi>10.1253/circj.CJ-19-0759</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Administrative Claims, Healthcare Aged Aged, 80 and over Cardiac rehabilitation Cluster Analysis Databases, Factual Electrophysiology Exploratory factor analysis Factor Analysis, Statistical Female Heart failure Heart Failure - diagnosis Heart Failure - mortality Heart Failure - therapy Hospital Mortality Hospitalization Humans Japan - epidemiology Male Retrospective Studies Risk Assessment Risk Factors Time Factors Treatment Outcome |
| title | Impact of Hospital Practice Factors on Mortality in Patients Hospitalized for Heart Failure in Japan ― An Analysis of a Large Number of Health Records From a Nationwide Claims-Based Database, the JROAD-DPC |
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