2021 Volume 43 Issue 4 Pages 306-312
Background and purpose: Since the financial health of developed countries is tight, not only medical relevance but also efficiency and economic rationality are important for maintaining medical care. Using data that reflected facilities throughout Japan, we conducted an exploratory study of factors associated with the length of hospital stay in patients with acute cerebral infarction who were treated with rt-PA. Methods: The rt-PA-administered patients included in the sampling data of National Database of Health Insurance Claims of Japan (NDB) obtained from the Ministry of Health, Labor and Welfare were divided into two groups: patients with a mean hospitalization period or longer and patients with a mean hospitalization period or shorter, and the factors related to the length of hospitalization were analyzed. Results: The factors associated with a long hospital stay were a 2-digit code of Japan Coma Scale at admission, enteral feeding, infection and laxative/enema prescription. Infections, which can be intervened after the onset of stroke, were estimated to affect an extended hospital stay of 3.8 days. Conclusions: Nationwide data analysis revealed the importance of infection control in shortening the hospitalization period for acute stroke. Promotion of infection prevention is important in terms of patient benefits and proper allocation of medical expenses.
