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Effective strategy for improving health care outcomes: Multidisciplinary care in cerebral infarction patients

Authors
 Kyu-Tae Han  ;  Eun-Cheol Park  ;  Sun Jung Kim  ;  Woorim Kim  ;  Myung-Il Hahm  ;  Sung-In Jang  ;  Sang Gyu Lee 
Citation
 HEALTH POLICY, Vol.119(8) : 1039-1045, 2015 
Journal Title
 HEALTH POLICY 
ISSN
 0168-8510 
Issue Date
2015
MeSH
Aged ; Cerebral Infarction/mortality ; Cerebral Infarction/therapy* ; Female ; Health Policy ; Humans ; Male ; Patient Care Team/organization & administration* ; Quality Improvement/organization & administration* ; Republic of Korea ; Treatment Outcome
Keywords
30-day mortality ; Collaborative care ; Multidisciplinary care ; Stroke
Abstract
Multidisciplinary teams provide effective patient treatment strategies. South Korea expanded its health program recently to include multidisciplinary treatment. This study characterized the relationship between multidisciplinary care and mortality within 30 days after hospitalization in cerebral infarction patients. We used the National Health Insurance claim data (n = 63,895) from 120 hospitals during 2010-2013 to analyze readmission within 30 days after hospitalization for cerebral infarction. We performed χ(2) tests, analysis of variance and multilevel modeling to investigate the associations between multidisciplinary care and death within 30 days after hospitalization for stroke. Deaths within 30 days of hospitalization due to cerebral infarction was 3.0% (n = 1898/63,895). Multidisciplinary care was associated with lower risk of death within 30 days in inpatients with cerebral infarction (odds ratio: 0.84, 95% confidence interval: 0.72-0.99). Patients treated by a greater number of specialists had lower risk of death within 30 days of hospitalization. Additional analyses showed that such associations varied by the combination of specialists (i.e., neurologist and neurosurgeon). In conclusion, death rates within 30 days of hospitalization for cerebral infarction were lower in hospitals with multidisciplinary care. Our findings certainly suggest that a high number of both neurosurgeon and neurologist is not always an effective alternative in managing stroke inpatients, and emphasize the importance of an optimal combination in the same number of hospital staffing.
Full Text
http://www.sciencedirect.com/science/article/pii/S0168851015001657
DOI
10.1016/j.healthpol.2015.06.005
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Lee, Sang Gyu(이상규) ORCID logo https://orcid.org/0000-0003-4847-2421
Jang, Sung In(장성인) ORCID logo https://orcid.org/0000-0002-0760-2878
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140701
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