The current status of cardiovascular medicine in Japan – Analysis of a large number of health records from a nationwide claim-based database, JROAD-DPC

JROAD Investigators

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background: Since cardiovascular disease accounts for one-quarter of deaths in the Japanese population, we developed a nationwide database using the administrative case-mix Diagnostic Procedure Combination (DPC) system (ie, the Japanese Registry Of All cardiac and vascular Diseases (JROAD)-DPC) to reveal the current status of cardiovascular medicine in Japan. Methods and Results: The JROAD-DPC database included 704,593 health records’ data of 2012 from 610 certificated hospitals of the Japanese Circulation Society. The 35,824 patients with acute myocardial infarction (AMI) and 108,665 patients with heart failure (HF) were admitted to hospitals. Increased hospital case volume was associated with reduced in-hospital mortality rates for both AMI and HF (P for trend <0.001). Although there was little variation among AMI patients in terms of aspirin use at discharge (median prescription rate, 83.0%; interquartile range [IQR], 76.9–88.0%), there were wide variations in the proportions of patients prescribed β-blockers (BB) and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin-receptor blockers (ARB) at discharge (BB, 41.4%, IQR 27.6–55.7%; ACEI/ARB, 52.0%, IQR 40.3–62.3%). In patients with HF, there were between-hospital variations in medications at discharge (BB, 38.1%, IQR, 27.8–47.6%; ACEI/ARB, 41.0%, IQR 31.7–49.1%). Conclusions: A nationwide administrative database of patients with cardiovascular diseases (JROAD-DPC) provided useful information that will contribute to improved quality of medical care, especially in the aging society of Japan, where HF has become an important health problem.

Original languageEnglish
Pages (from-to)2327-2335
Number of pages9
JournalCirculation Journal
Volume80
Issue number11
DOIs
Publication statusPublished - 2016

Fingerprint

Japan
Medicine
Databases
Heart Failure
Angiotensin Receptor Antagonists
Health
Angiotensin-Converting Enzyme Inhibitors
Myocardial Infarction
Cardiovascular Diseases
Quality of Health Care
Diagnosis-Related Groups
Hospital Mortality
Vascular Diseases
Aspirin
Prescriptions
Registries
Heart Diseases
Mortality
Population

Keywords

  • Acute myocardial infarction
  • Cardiovascular diseases
  • Cross-sectional analyses
  • Heart failure
  • Quality of medical care

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

The current status of cardiovascular medicine in Japan – Analysis of a large number of health records from a nationwide claim-based database, JROAD-DPC. / JROAD Investigators.

In: Circulation Journal, Vol. 80, No. 11, 2016, p. 2327-2335.

Research output: Contribution to journalArticle

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abstract = "Background: Since cardiovascular disease accounts for one-quarter of deaths in the Japanese population, we developed a nationwide database using the administrative case-mix Diagnostic Procedure Combination (DPC) system (ie, the Japanese Registry Of All cardiac and vascular Diseases (JROAD)-DPC) to reveal the current status of cardiovascular medicine in Japan. Methods and Results: The JROAD-DPC database included 704,593 health records’ data of 2012 from 610 certificated hospitals of the Japanese Circulation Society. The 35,824 patients with acute myocardial infarction (AMI) and 108,665 patients with heart failure (HF) were admitted to hospitals. Increased hospital case volume was associated with reduced in-hospital mortality rates for both AMI and HF (P for trend <0.001). Although there was little variation among AMI patients in terms of aspirin use at discharge (median prescription rate, 83.0{\%}; interquartile range [IQR], 76.9–88.0{\%}), there were wide variations in the proportions of patients prescribed β-blockers (BB) and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin-receptor blockers (ARB) at discharge (BB, 41.4{\%}, IQR 27.6–55.7{\%}; ACEI/ARB, 52.0{\%}, IQR 40.3–62.3{\%}). In patients with HF, there were between-hospital variations in medications at discharge (BB, 38.1{\%}, IQR, 27.8–47.6{\%}; ACEI/ARB, 41.0{\%}, IQR 31.7–49.1{\%}). Conclusions: A nationwide administrative database of patients with cardiovascular diseases (JROAD-DPC) provided useful information that will contribute to improved quality of medical care, especially in the aging society of Japan, where HF has become an important health problem.",
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author = "{JROAD Investigators} and Satoshi Yasuda and Kazuhiro Nakao and Kunihiro Nishimura and Yoshihiro Miyamoto and Yoko Sumita and Toshiaki Shishido and Toshihisa Anzai and Hiroyuki Tsutsui and Hiroshi Itoh and Issei Komuro and Yoshihiko Saito and Hisao Ogawa",
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AU - JROAD Investigators

AU - Yasuda, Satoshi

AU - Nakao, Kazuhiro

AU - Nishimura, Kunihiro

AU - Miyamoto, Yoshihiro

AU - Sumita, Yoko

AU - Shishido, Toshiaki

AU - Anzai, Toshihisa

AU - Tsutsui, Hiroyuki

AU - Itoh, Hiroshi

AU - Komuro, Issei

AU - Saito, Yoshihiko

AU - Ogawa, Hisao

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AB - Background: Since cardiovascular disease accounts for one-quarter of deaths in the Japanese population, we developed a nationwide database using the administrative case-mix Diagnostic Procedure Combination (DPC) system (ie, the Japanese Registry Of All cardiac and vascular Diseases (JROAD)-DPC) to reveal the current status of cardiovascular medicine in Japan. Methods and Results: The JROAD-DPC database included 704,593 health records’ data of 2012 from 610 certificated hospitals of the Japanese Circulation Society. The 35,824 patients with acute myocardial infarction (AMI) and 108,665 patients with heart failure (HF) were admitted to hospitals. Increased hospital case volume was associated with reduced in-hospital mortality rates for both AMI and HF (P for trend <0.001). Although there was little variation among AMI patients in terms of aspirin use at discharge (median prescription rate, 83.0%; interquartile range [IQR], 76.9–88.0%), there were wide variations in the proportions of patients prescribed β-blockers (BB) and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin-receptor blockers (ARB) at discharge (BB, 41.4%, IQR 27.6–55.7%; ACEI/ARB, 52.0%, IQR 40.3–62.3%). In patients with HF, there were between-hospital variations in medications at discharge (BB, 38.1%, IQR, 27.8–47.6%; ACEI/ARB, 41.0%, IQR 31.7–49.1%). Conclusions: A nationwide administrative database of patients with cardiovascular diseases (JROAD-DPC) provided useful information that will contribute to improved quality of medical care, especially in the aging society of Japan, where HF has become an important health problem.

KW - Acute myocardial infarction

KW - Cardiovascular diseases

KW - Cross-sectional analyses

KW - Heart failure

KW - Quality of medical care

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