Abstract
Diabetes has become a growing concern in Japan, both medically and financially. The medical cost of diabetes was estimated at 1215 billion yen for fiscal year 2011. We analyzed the length of stay (LOS) in a hospital for type 2 diabetes mellitus patients who participated in educational programs to determine factors affecting LOS. Data on 991 patients obtained from 28 Red Cross hospitals in 2008 were used. For the analysis, we used the Box-Cox transformation model and Hausman test. The results revealed that patients aged 75 years and above and those with comorbidities and complications were prone to longer LOS. The analysis also revealed significant differences in LOS across the hospitals, even after controlling for patient characteristics. Finally, we applied the least squares method to determine the effects of hospital and regional factors and revealed that patients’ LOS was affected by the region’s average LOS. Regional corporations and networks appeared to be important in improving educational programs.
Highlights
The growing incidence of diabetes has become both a medical and financial concern in Japan
In 2009 [7], average length of stay (ALOS) with diabetes as first-listed diagnosis was 5.0 days in the United States, whereas the present study reports that the ALOS of diabetes patients in Japan was 18.3 days
Where βi is the estimate of Hospital i Dummy,Beds denotes the number of beds and the size of the hospital, Bed Density is the number of beds per 100 thousand people, Population Density is population density per km2, and Average Stay is the ALOS of all patients for general hospitals in the prefecture where the hospital is located
Summary
The growing incidence of diabetes has become both a medical and financial concern in Japan. (2015) Evaluation of Length of Hospital Stay Joining Educational Programs for Type 2 Diabetes Mellitus Patients: Can We Control Medical Costs in Japan? 2011, the medical costs for diabetes were estimated at 1215 billion yen or 3.1% of Japan’s total medical expenditure (38,585 billion yen) [1]. This concern is not limited to Japan. The American Diabetes Association [3] estimated the total cost of diagnosed diabetes in the United States at $245 billion in 2012, comprising $176 billion as direct medical costs and $69 billion from reduced productivity. In Australia, the proportion of individuals with diabetes increased from 1.5% of the total population in 1989-1990 to 4.1% in 2007-2008; diabetes accounted for 2% of total medical expenses and one out of every 25 cases requiring hospitalization in 2009-2010 [4]
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