Effective strategy for improving health care outcomes: Multidisciplinary care in cerebral infarction patients |
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| Affiliation: | 1. Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea;2. Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea;3. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea;4. Department of Health Administration, Namseoul University, Cheonan, Republic of Korea;5. Department of Health Administration and Management, Soonchunhyang University, Asan, Republic of Korea;6. Department of Hospital Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea;1. Center for Healthy Aging, Section for Health Services Research, Department of Public Health, University of Copenhagen, Demark;2. Section for Health Services Research, Department of Public Health, University of Copenhagen, Denmark;3. Section for General Practice, Department of Public Health, University of Copenhagen, Denmark;1. Heron Evidence Development AB, Stockholm, Sweden;2. Karolinska Institutet, Stockholm, Sweden;3. The Swedish Agency for Health and Care Services Analysis, Stockholm, Sweden;1. AQUA Institute for Applied Quality Improvement and Research in Health Care GmbH, Maschmühlenweg 8–10, 37073 Göttingen, Germany;2. Institute for Epidemiology, Social Medicine and Health System Research, Hanover Medical School, Carl-Neuberg-Straße 1, 30625 Hanover, Germany;3. Department of General Practice and Health Services Research, Universitätsklinikum Heidelberg, Voßstraße 2, 69115 Heidelberg, Germany;1. Department of Public Health, Bartholins Alle 2, Aarhus University, 8000 Aarhus, Denmark;2. Department of Clinical Medicine, Palle Juul-Jensens Boulevard 82, Aarhus University, 8200 Aarhus N, Denmark;3. Health Economics, CFK - Public Health and Quality Improvement, Oluf Palmes Alle 15, Central Denmark Region, 8200 Aarhus N, Denmark;4. Manchester Centre for Health Economics, Institute of Population Health, University of Manchester, Oxford Road, M13 9PL Manchester, UK;5. COHERE - Centre for Health Economic Research, Department of Business and Economics, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark |
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| 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 χ2 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. |
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| Keywords: | Collaborative care Multidisciplinary care Stroke 30-day mortality |
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