Evidence map›Paper›PMID 38170111›Full record

ArticleHeliyon2024

Association between hospital spending and in-hospital mortality of patients with sepsis based on a Japanese nationwide medical claims database study.

Takehiko Oami, Toshikazu Abe, Taka-Aki Nakada, Taro Imaeda, Tuerxun Aizimu, Nozomi Takahashi, Yasuo Yamao, Satoshi Nakagawa, Hiroshi Ogura, Nobuaki Shime and 3 more

Abstract read
In one paragraph

Article in Heliyon, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Takehiko OamiDepartment of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Toshikazu AbeHealth Services Research and Development Center, University of Tsukuba, Tsukuba, Japan.
Taka-Aki NakadaDepartment of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Taro ImaedaDepartment of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Tuerxun AizimuDepartment of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Nozomi TakahashiDepartment of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Yasuo YamaoDepartment of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Satoshi NakagawaDepartment of Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan.
Hiroshi OguraDepartment of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Nobuaki ShimeDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Yutaka UmemuraDepartment of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Asako MatsushimaDepartment of Emergency and Critical Care, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan.
Kiyohide FushimiDepartment of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The effect of hospital spending on the mortality rate of patients with sepsis has not yet been fully elucidated. We hypothesized that hospitals that consume more medical resources would have lower mortality rates among patients with sepsis. Methods: This retrospective study used administrative data from 2010 to 2017. The enrolled hospitals were divided into quartiles based on average daily medical cost per sepsis case. The primary and secondary outcomes were the average in-hospital mortality rate of patients with sepsis and the effective cost per survivor among the enrolled hospitals, respectively. A multiple regression model was used to determine the significance of the differences among hospital categories to adjust for baseline imbalances. Results: Among 997 hospitals enrolled in this study, the crude in-hospital mortality rates were 15.7% and 13.2% in the lowest and highest quartiles of hospital spending, respectively. After adjusting for confounding factors, the highest hospital spending group demonstrated a significantly lower in-hospital mortality rate than the lowest hospital spending group (coefficient = -0.025, 95% confidence interval [CI] -0.034 to -0.015; p < 0.0001). Similarly, the highest hospital spending group was associated with a significantly higher effective cost per survivor than the lowest hospital spending group (coefficient = 77.7, 95% CI 73.1 to 82.3; p < 0.0001). In subgroup analyses, hospitals with a small or medium number of beds demonstrated a consistent pattern with the primary test, whereas those with a large number of beds or academic affiliations displayed no association. Conclusions: Using a nationwide Japanese medical claims database, this study indicated that hospitals with greater expenditures were associated with a superior survival rate and a higher effective cost per survivor in patients with sepsis than those with lower expenditures. In contrast, no correlations between hospital spending and mortality were observed in hospitals with a large number of beds or academic affiliations.

Indexed as

Critical careDiagnosis procedure combinationHospital spendingMedical costSepsis

Identifiers

PMID38170111
PMCPMC10758802

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.