Postoperative mortality analysis of national Japanese Diagnosis Procedure Combination database with a focus on regional comparisons and changes over time

Abstract

AbstractPURPOSEThis study aimed to investigate postoperative mortality from all surgeries at the prefecture level using nationwide database, Japanese Diagnosis Procedure Combination (DPC) database, and to show those with visible changes over time or variations among areas.METHODSData were provided in accordance with the guidelines and application as indicated on the Ministry of Health, Labor and Welfare (MHLW), Japan. The number of cases and in-hospital mortality were calculated for each representative surgery for each hospitalization by fiscal year of discharge from 2011 to 2018 and by prefecture. Values of ≥10 in each aggregated data cell are presented.RESULTSThe aggregated result data contain 474,154 records, with about 2000 different surgical codes. Only in the 16,890 data, more than 10 mortalities were recorded, which can be used in the mortality analysis. In the analyses of artificial head insertion, cerebral aneurysm neck clipping, coronary artery and aortic bypass grafting, and tracheotomy, regional differences and a declining trend were observed in some categories.CONCLUSIONIn addition to considering categories that can be used in the analysis, careful consideration must be given to the inclusion of background context such as quality of care.