The Japanese medical costs for cataract treatments reached 270 billion yen in fiscal year 2012. Since the length of stay (LOS) in hospital is much longer than other major countries, controlling the medical costs by re...The Japanese medical costs for cataract treatments reached 270 billion yen in fiscal year 2012. Since the length of stay (LOS) in hospital is much longer than other major countries, controlling the medical costs by reducing LOS becomes an important issue in Japan. In this paper, we evaluated the effects of the 2010 revision of the Japanese medical payment system (DPC/PDPS) on LOS for cataract operations. The Box-Cox transformation model, Nawata’s estimators and Hausman tests were used in the analysis. To evaluate the effects, we analyzed a dataset obtained from 34 DPC hospitals (Hp1-34) where one-eye cataract operations were performed both before (April 2008-March 2010) and after (April 2010-March 2012) the 2010 revision and there were more than 500 patients. The dataset contained information from 32,593 patients. We did not admit the effect of the 2010 revision in this study, and there were large differences LOS among hospitals, even after removing the influences of factors such as patient characteristics and types of principal diseases.展开更多
Objective :To introduce the work of the prevention and treatment of blindness of Zhongshan Ophthalmic Center, to find out the effective model of blindness prevention and treatment in China.Method; 1. To provide high q...Objective :To introduce the work of the prevention and treatment of blindness of Zhongshan Ophthalmic Center, to find out the effective model of blindness prevention and treatment in China.Method; 1. To provide high quality clinical service to rural people. 2. To conduct epidemio-logical survey 3.To train local ophthalmic professionals 4.To promote international cooperation.Result:40 000 outpatients cases, 4 500 cataract surgeries have been accomplished. Thousands cataract blind have been rehabilitated. 9 papers concerning epidemiological survey have been published. After the international training courses, 50 local ophthalmic workers have been trained and 4 cataract surgery rehabilitation centers have been founded. Conclusion : An effective model for blindness prevention and treatment should be based on clinical service, population based epidemiological survey and local ophthalmic professionals training. International cooperation is also an important promoter. Eye Science 1997; 13 : 162 -163.展开更多
In this paper, we conducted a long term survey of the cataract surgeries. The sample period was about 7 years, from July 2005 to March 2012. We evaluated the effects of three revisions of the medical payment system th...In this paper, we conducted a long term survey of the cataract surgeries. The sample period was about 7 years, from July 2005 to March 2012. We evaluated the effects of three revisions of the medical payment system that were done in 2006, 2008 and 2010. For the analysis, the Box-Cox transformation model and Hausman test using Nawata’s estimator were used for the length of stay (LOS) in hospitals, and the ordinary least squares method was used for the non-inclusive (mainly payments for surgeries) payments. We analyzed a dataset of 51,054 patients obtained from 60 hospitals (Hp1-60) where more than 300 one-eye cataract surgeries were performed during the period. For the LOS, we found that only the 2008 revision had significant impact on shortening the LOS but the other two did not. We also found very large differences among hospitals even after eliminating effects of patients’ characteristics and type of principle diseases as previous studies. For non-inclusive payments 2006 and 2008 revisions had significant impacts and the differences among hospitals were much smaller than those of the LOS.展开更多
文摘The Japanese medical costs for cataract treatments reached 270 billion yen in fiscal year 2012. Since the length of stay (LOS) in hospital is much longer than other major countries, controlling the medical costs by reducing LOS becomes an important issue in Japan. In this paper, we evaluated the effects of the 2010 revision of the Japanese medical payment system (DPC/PDPS) on LOS for cataract operations. The Box-Cox transformation model, Nawata’s estimators and Hausman tests were used in the analysis. To evaluate the effects, we analyzed a dataset obtained from 34 DPC hospitals (Hp1-34) where one-eye cataract operations were performed both before (April 2008-March 2010) and after (April 2010-March 2012) the 2010 revision and there were more than 500 patients. The dataset contained information from 32,593 patients. We did not admit the effect of the 2010 revision in this study, and there were large differences LOS among hospitals, even after removing the influences of factors such as patient characteristics and types of principal diseases.
基金THis paper is supported by Guangdong science and technology commission
文摘Objective :To introduce the work of the prevention and treatment of blindness of Zhongshan Ophthalmic Center, to find out the effective model of blindness prevention and treatment in China.Method; 1. To provide high quality clinical service to rural people. 2. To conduct epidemio-logical survey 3.To train local ophthalmic professionals 4.To promote international cooperation.Result:40 000 outpatients cases, 4 500 cataract surgeries have been accomplished. Thousands cataract blind have been rehabilitated. 9 papers concerning epidemiological survey have been published. After the international training courses, 50 local ophthalmic workers have been trained and 4 cataract surgery rehabilitation centers have been founded. Conclusion : An effective model for blindness prevention and treatment should be based on clinical service, population based epidemiological survey and local ophthalmic professionals training. International cooperation is also an important promoter. Eye Science 1997; 13 : 162 -163.
文摘In this paper, we conducted a long term survey of the cataract surgeries. The sample period was about 7 years, from July 2005 to March 2012. We evaluated the effects of three revisions of the medical payment system that were done in 2006, 2008 and 2010. For the analysis, the Box-Cox transformation model and Hausman test using Nawata’s estimator were used for the length of stay (LOS) in hospitals, and the ordinary least squares method was used for the non-inclusive (mainly payments for surgeries) payments. We analyzed a dataset of 51,054 patients obtained from 60 hospitals (Hp1-60) where more than 300 one-eye cataract surgeries were performed during the period. For the LOS, we found that only the 2008 revision had significant impact on shortening the LOS but the other two did not. We also found very large differences among hospitals even after eliminating effects of patients’ characteristics and type of principle diseases as previous studies. For non-inclusive payments 2006 and 2008 revisions had significant impacts and the differences among hospitals were much smaller than those of the LOS.
