Classification of long-term care wards and their functional characteristics: analysis of national hospital data in Japan
Abstract Background In a rapidly aging society that has promoted extensive reforms of the healthcare system, clarifying functional patterns in long-term care wards is important for developing regional healthcare policies. This study aimed to classify patterns of inpatient characteristics among Japan...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-08-01
|
| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-018-3468-0 |
| _version_ | 1828496383672320000 |
|---|---|
| author | Ayumi Igarashi Noriko Yamamoto-Mitani Kojiro Morita Hiroki Matsui Claudia K.Y. Lai Hideo Yasunaga |
| author_facet | Ayumi Igarashi Noriko Yamamoto-Mitani Kojiro Morita Hiroki Matsui Claudia K.Y. Lai Hideo Yasunaga |
| author_sort | Ayumi Igarashi |
| collection | DOAJ |
| description | Abstract Background In a rapidly aging society that has promoted extensive reforms of the healthcare system, clarifying functional patterns in long-term care wards is important for developing regional healthcare policies. This study aimed to classify patterns of inpatient characteristics among Japanese long-term care wards and to examine hospital/ward characteristics. Methods We analyzed data from 1856 long-term care wards extracted from the 2014 Annual Report for Functions of Medical Institutions in Japan. We classified five clusters of long-term care wards based on inpatients’ medical acuity/activities of daily living using cluster analysis, and compared hospital/ward characteristics across the clusters with a chi-square test or analyses of variance. Results Cluster 1 was low medical acuity/high activities of daily living (n = 175); cluster 2, medium medical acuity/high activities of daily living (n = 340); cluster 3, medium medical acuity/low activities of daily living (n = 461); cluster 4, high medical acuity/low activities of daily living (n = 409); and cluster 5, mixed (n = 471). Although clusters 1 and 2 had similar higher proportions of home discharge (48.1% and 34.6%, respectively), there was a difference in length of hospital stay between the clusters (154.6 and 216.6 days, respectively). On the other hand, clusters 3 and 4 experienced a longer length of hospital stay (295.7 and 239.8 days, respectively) and a higher proportion of in-hospital deaths (42.7% and 50.2%, respectively). Characteristics of cluster 5 were not significantly different from the average of overall wards. Conclusions There were distinctive differences across hospitals in their use of long-term care wards. Wards with different functions have different support needs; the clusters with high activities of daily living needed support in promoting home discharge, while those with low activities of daily living needed support in providing quality end-of-life care. Our results can be useful for constructing the future regional healthcare system. This study also suggests introducing a standardized patient classification system in long-term care settings. |
| first_indexed | 2024-12-11T12:28:52Z |
| format | Article |
| id | doaj.art-fbe9d8bf688447f186a4324c6f5cc664 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-11T12:28:52Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-fbe9d8bf688447f186a4324c6f5cc6642022-12-22T01:07:18ZengBMCBMC Health Services Research1472-69632018-08-011811810.1186/s12913-018-3468-0Classification of long-term care wards and their functional characteristics: analysis of national hospital data in JapanAyumi Igarashi0Noriko Yamamoto-Mitani1Kojiro Morita2Hiroki Matsui3Claudia K.Y. Lai4Hideo Yasunaga5Department of Gerontological Home Care and Long-term Care Nursing, School of Health Sciences & Nursing, Graduate School of Medicine, The University of TokyoDepartment of Gerontological Home Care and Long-term Care Nursing, School of Health Sciences & Nursing, Graduate School of Medicine, The University of TokyoDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of TokyoDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of TokyoSchool of Nursing, The Hong Kong Polytechnic UniversityDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of TokyoAbstract Background In a rapidly aging society that has promoted extensive reforms of the healthcare system, clarifying functional patterns in long-term care wards is important for developing regional healthcare policies. This study aimed to classify patterns of inpatient characteristics among Japanese long-term care wards and to examine hospital/ward characteristics. Methods We analyzed data from 1856 long-term care wards extracted from the 2014 Annual Report for Functions of Medical Institutions in Japan. We classified five clusters of long-term care wards based on inpatients’ medical acuity/activities of daily living using cluster analysis, and compared hospital/ward characteristics across the clusters with a chi-square test or analyses of variance. Results Cluster 1 was low medical acuity/high activities of daily living (n = 175); cluster 2, medium medical acuity/high activities of daily living (n = 340); cluster 3, medium medical acuity/low activities of daily living (n = 461); cluster 4, high medical acuity/low activities of daily living (n = 409); and cluster 5, mixed (n = 471). Although clusters 1 and 2 had similar higher proportions of home discharge (48.1% and 34.6%, respectively), there was a difference in length of hospital stay between the clusters (154.6 and 216.6 days, respectively). On the other hand, clusters 3 and 4 experienced a longer length of hospital stay (295.7 and 239.8 days, respectively) and a higher proportion of in-hospital deaths (42.7% and 50.2%, respectively). Characteristics of cluster 5 were not significantly different from the average of overall wards. Conclusions There were distinctive differences across hospitals in their use of long-term care wards. Wards with different functions have different support needs; the clusters with high activities of daily living needed support in promoting home discharge, while those with low activities of daily living needed support in providing quality end-of-life care. Our results can be useful for constructing the future regional healthcare system. This study also suggests introducing a standardized patient classification system in long-term care settings.http://link.springer.com/article/10.1186/s12913-018-3468-0Cluster analysisHealthcare policyHealthcare reformHospitalLong-term care ward |
| spellingShingle | Ayumi Igarashi Noriko Yamamoto-Mitani Kojiro Morita Hiroki Matsui Claudia K.Y. Lai Hideo Yasunaga Classification of long-term care wards and their functional characteristics: analysis of national hospital data in Japan BMC Health Services Research Cluster analysis Healthcare policy Healthcare reform Hospital Long-term care ward |
| title | Classification of long-term care wards and their functional characteristics: analysis of national hospital data in Japan |
| title_full | Classification of long-term care wards and their functional characteristics: analysis of national hospital data in Japan |
| title_fullStr | Classification of long-term care wards and their functional characteristics: analysis of national hospital data in Japan |
| title_full_unstemmed | Classification of long-term care wards and their functional characteristics: analysis of national hospital data in Japan |
| title_short | Classification of long-term care wards and their functional characteristics: analysis of national hospital data in Japan |
| title_sort | classification of long term care wards and their functional characteristics analysis of national hospital data in japan |
| topic | Cluster analysis Healthcare policy Healthcare reform Hospital Long-term care ward |
| url | http://link.springer.com/article/10.1186/s12913-018-3468-0 |
| work_keys_str_mv | AT ayumiigarashi classificationoflongtermcarewardsandtheirfunctionalcharacteristicsanalysisofnationalhospitaldatainjapan AT norikoyamamotomitani classificationoflongtermcarewardsandtheirfunctionalcharacteristicsanalysisofnationalhospitaldatainjapan AT kojiromorita classificationoflongtermcarewardsandtheirfunctionalcharacteristicsanalysisofnationalhospitaldatainjapan AT hirokimatsui classificationoflongtermcarewardsandtheirfunctionalcharacteristicsanalysisofnationalhospitaldatainjapan AT claudiakylai classificationoflongtermcarewardsandtheirfunctionalcharacteristicsanalysisofnationalhospitaldatainjapan AT hideoyasunaga classificationoflongtermcarewardsandtheirfunctionalcharacteristicsanalysisofnationalhospitaldatainjapan |