1.Factors Affecting Length of Hospitalization of Elderly Patients with Urinary Tract Infection Managed Mainly by General Practitioners
Hitomi OSAKABE ; Satomi TAKEMOTO ; Yumi SHIMADA ; Keiko NAKATA ; Naomi YAMADA ; Yutaka MINEMATSU ; Masahisa ARAHATA
An Official Journal of the Japan Primary Care Association 2023;46(3):89-95
Introduction: The purpose of this study was to identify factors affecting the length of hospitalization of elderly patients with urinary tract infection (UTI) in an acute care hospital, where general practitioners treat the majority of them.Methods: Subjects were patients aged ≥ 65 years with UTI who were admitted to our hospital between April 2019 and March 2021. The primary endpoint was the length of hospital stay on an acute care ward. Factors associated with the primary endpoint were detected using logistic regression analysis with several explanatory variables (patients' baseline characteristics, laboratory findings, and interventions during hospitalization).Results: In total, 143 cases were eligible for analysis (88±7 years old, 37% male). Multivariate logistic regression analysis revealed that: Charlson Comorbidity Index ≥ 6, complex UTI with urologist's assessment, and the score of the Functional Oral Intake Scale (FOIS) on admission were significant factors correlated with the length of hospitalization (odds ratios: 5.07, 0.13, and 0.30, respectively).Conclusion: In older patients with UTI, CCI≥6, UTI without urologist's assessment, and a lower score of FOIS may prolong the length of stay in an acute care hospital.
2.A Survey Regarding the Price Calculation Method for New Drugs Based on the Chuikyo-Document about the NHI Drug Price List
Shiori HASEGAWA ; Yamato KATO ; Toshinobu MATSUI ; Haruna HATAHIRA ; Sayaka SASAOKA ; Yumi MOTOOKA ; Satoshi NAKAO ; Ririka MUKAI ; Kazuyo SHIMADA ; Natsumi UEDA ; Mitsuhiro NAKAMURA
Japanese Journal of Drug Informatics 2018;20(2):120-128
In Japan, the National Health Insurance (NHI) prices of new drugs are set according to the NHI Drug Price Standard (NHI Price Standard). The NHI Price Standard was notified by the Ministry of Health, Labour, and Welfare based on the ”Drug Price Calculation Criteria” proposed by the Central Social Insurance Medical Council (Chuikyo) in Japan. The NHI Price Standard affects the research and development strategy of pharmaceutical companies. In order to discover undetected relationships, the factors influencing the ”drug price” were evaluated through the association rule mining technique. We surveyed the Chuikyo‐documents about NHI price listing over the period October 27, 2006 to February 8, 2007. The number of approved new drugs was 874, while that of drugs completed (”drug price per day”) was 314. The numbers of new compounds corresponding to a drug price per day of ”below 200 yen,” ”between 200 yen and 1,000 yen,” ”between 1,000 and 10,000 yen,” and ”above or equal to 10,000 yen” were 87 (27.7%), 91 (29.0%), 79 (25.2%), and 57 (18.2%), respectively. In the association rule mining method, we observed high lift values of the combined items ”above or equal to 30,000 patients expected to be administrated” and ”drugs affecting sensory organs” in the group of drug price per day below 200 yen. The lift values of the combinations of ”biological preparations” and ”similar efficacy comparison‐based price setting (Ⅱ)” or ”below 30,000 patients expected to be administrated” and ”antineoplastic drug” in the group of ”above or equal to 10,000 yen of drug price per day” were high. These results provide a basis for the development and application of new drugs in Japan.