The Trend in Acute Care of Patients of Saiseikai Hospital in the Pre-COVID, COVID-Pandemic, and Post-COVID Periods

Abstract

Objective: The number of acute care inpatients in Saiseikai Hospitals in the post-COVID period starting May 2023 has not recovered to the level of the pre-COVID period. In order to provide useful findings to make a counteracting plan for the Saiseikai Social Welfare Corporation as a whole, this study aimed at analyzing the DPC data, which are the standardized national claim data for acute care inpatients, to elucidate the difference in acute care inpatients between pre-COVID, COVID-pandemic, and post-COVID periods.

Methods: Refer to body
Results: Among 64 participating hospitals, 49 hospitals (77%) showed a decrease of 10% or more in the average daily number of hospitalized patients in the post-COVID period as compared to the pre-COVID period. Of these 49 hospitals, 34 hospitals (69%) showed a decrease of 10% or more in the average length of hospital stay, and 16 hospitals (33%) showed a decrease of 10% or more in the monthly number of newly admitted patients in the post-COVID period as compared to the pre-COVID period. The decrease in the average length of hospital stay was smaller from the pre-COVID to the COVID-pandemic period when compared with the decrease from the pre-COVID to the post-COVID period. The average length of hospital stay decreased in almost all main disease groups at admission in the post-COVID period as compared to the pre-COVID period, suggesting the decrease in average length of hospital stay was due to comprehensive efforts to decrease it as a hospital as a whole. In many hospitals, the decrease in the monthly number of newly admitted patients was larger than the decrease in the population of local municipalities, thus contributing to the decrease in the average daily number of hospitalized patients together with the decrease in the average length of hospital stay. On the other hand, in hospitals in which the decrease in the average daily number of hospitalized patients was less than 10% or even increasing, the average daily number of hospitalized patients increased from the pre-COVID to the post-COVID period, successfully maintaining the average daily number of hospitalized patients.

Discussion: The reason for the decrease in the average length of hospital stay was presumably due to the upcoming change in the limit of the average length of hospital stay in the 2024 revision of medical fees. If this shortening of the limit of the average length of hospital stay continues, it is necessary to increase the number of newly admitted patients in order to maintain the average daily number of hospitalized patients. In the 2045 population projections for local municipalities from which acute care inpatients come to Saiseikai Hospitals, the population of people aged 15 to 64 is estimated to decrease to 80% of the 2018–2019 population level, whereas the decrease for the population aged 64 to 75 is estimated at 98% and that for ages 75 and over is estimated at 133%. These projections indicate that it will become more important to focus on the acute care of elderly inpatients.

Conclusion: The decrease in the number of acute care inpatients in Saiseikai Hospitals is due to the shortening of the length of hospital stay. There is no easy way to increase the number of newly admitted patients in light of the country’s upcoming population shrinkage. It is necessary to focus more on elderly inpatients, whose population is expected to increase in the future.