aki yoshikawa - Academia.edu (original) (raw)

Papers by aki yoshikawa

Japanese Circulation Journal-english Edition, 1999

Journal of Cardiology, 2018

a retrospective multicenter study that aimed to show the real clinical practice for ISMAD patient... more a retrospective multicenter study that aimed to show the real clinical practice for ISMAD patients. Methods Study design and data sources This was a retrospective study using Diagnosis Procedure Combination (DPC) data collected between January 2015 and December 2015. These data were collected from 141 Japanese hospitals that had agreed to its secondary usage. The requirement for informed consent was waived as the data were anonymized. The DPC data included the following: patient age and sex; main diagnoses and comorbidities, recorded with both International Classification of Diseases (Tenth Revision) (ICD-10) codes and text data written in Japanese; New York Heart Association (NYHA) functional class at admission; drugs and devices; diagnostic and

California Management Review, 1989

International journal of cardiology, Jan 15, 2017

The usefulness of carperitide in patients with acute heart failure (AHF) has not been confirmed; ... more The usefulness of carperitide in patients with acute heart failure (AHF) has not been confirmed; carperitide is expensive, and thus, its routine use has not been shown to add much value in clinical settings. We analyzed the impact of carperitide usage on the outcome and cost of hospitalization in AHF patients. Data obtained from the Diagnosis Procedure Combination (DPC) database from July 2014 until June 2015 from 371 hospitals were analyzed. Emergent patients with acute heart failure (ICD code I50* and DPC code 050130) who did not undergo any surgical procedures were enrolled. We compared the outcomes and cost between the carperitide group and non-carperitide group using propensity score matched analysis. In 37,891 heart failure patients (52.2% male; 79.2±11.9years), 13,421 pairs were selected according to the propensity score matching. In-hospital death occurred more frequently in the carperitide group (n=997; 7.4%) than in the non-carperitide group (n=844; 6.3%; p<0.01). Carpe...

Rinsho yakuri/Japanese Journal of Clinical Pharmacology and Therapeutics, 2000

The Journal of Technology Transfer, 1990

... Aki Yoshikawa, Ph.D., an industrial economist, is a ttayase Fellow at the Northeast Asia-Unit... more ... Aki Yoshikawa, Ph.D., an industrial economist, is a ttayase Fellow at the Northeast Asia-United States Forum on Inter-national Policy at Stanford University. ... billion (15-trillion yen) in Japan alone (see Table 1). Table 1. Impact of Biotechnology in Japanese Market. ...

The Journal of Human Resources, 1996

ABSTRACT We estimate the price elasticity of demand for outpatient care in Japan. We use a nation... more ABSTRACT We estimate the price elasticity of demand for outpatient care in Japan. We use a nationally representative microdata set consisting of nearly 440,000 Japanese patients. Using time between outpatient visits as a de-mand measure, we estimate a Cox proportional ...

Japanese Journal of Clinical Oncology, 2010

Most clinical pathways in treating cancers in Japan are based on individual physician's personal ... more Most clinical pathways in treating cancers in Japan are based on individual physician's personal experiences rather than on an empirical analysis of clinical data such as benchmark comparison with other hospitals. Therefore, these pathways are far from being standardized. By comparing detailed clinical data from five cancer centers, we have observed various differences among hospitals. By conducting benchmark analyses, providing detailed feedback to the participating hospitals and by repeating the benchmark a year later, we strive to develop more standardized clinical pathways for the treatment of cancers. The Cancer Quality Initiative was launched in 2007 by five cancer centers. Using diagnosis procedure combination data, the member hospitals benchmarked their pre-operative and post-operative length of stays, the duration of antibiotics administrations and the post-operative fasting duration for gastric, colon and rectal cancers. The benchmark was conducted by disclosing hospital identities and performed using 2007 and 2008 data. In the 2007 benchmark, substantial differences were shown among five hospitals in the treatment of gastric, colon and rectal cancers. After providing the 2007 results to the participating hospitals and organizing several brainstorming discussions, significant improvements were observed in the 2008 data study. The benchmark analysis of clinical data is extremely useful in promoting more standardized care and, thus in improving the quality of cancer treatment in Japan. By repeating the benchmark analyses, we can offer truly clinical evidence-based higher quality standardized cancer treatment to our patients.

International Journal of Technology Assessment in Health Care, 1996

We examined staffing levels, acquisition of medical technologies, and utilization of those techno... more We examined staffing levels, acquisition of medical technologies, and utilization of those technologies in private and government teaching hospitals in Japan. Adjusting for size and case mix, we found that government hospitals acquire more technology, use that technology less, and employ a more highly skilled staff than do private hospitals.

International Journal of Health Services, 1995

This study uses cross-sectional data from Japan's 47 prefectures covering subscribers to Japa... more This study uses cross-sectional data from Japan's 47 prefectures covering subscribers to Japan's National Health Insurance system to analyze the effects of income and copayment levels on the utilization of medical care. Multivariate regression models were run for the years 1984 and 1989, with the utilization ratio (number of health insurance claims per 100 insurance subscribers) for total, inpatient, outpatient, and dental services as the dependent variable. Independent variables included copayment per patient day, deflated per capita income, population density, percentage of subscribers over age 65, number of beds and clinics per 1,000 persons, and number of doctors and dentists per 1,000 persons. The data were then stratified according to per capita income and percentage of insurance subscribers over the age of 65 in each prefecture. The copayment amount exhibited a small, but significant negative effect on the utilization of all medical services. Utilization of outpatient...

Stan. L. & Pol'y Rev., 1991

... Doctors and Hospitals in a Universal Health Care System by Aki Yoshikawa Norihiko Shirouzu Ma... more ... Doctors and Hospitals in a Universal Health Care System by Aki Yoshikawa Norihiko Shirouzu Matthew Holt As the sobering realities of spiraling ... In 1987, Japan spent 6.8% of its Gross Domestic Product (GDP), or 23.853 trillion yen, on health care.6 Other industrially advanced ...

Asian Survey, 1985

Small is Beautiful Industrially advanced countries are just now beginning to realize that the pro... more Small is Beautiful Industrially advanced countries are just now beginning to realize that the promotion of smaller enterprises-including the socalled venture businesses-is indispensable to the maintenance of a flexible economic structure. In Japan, smaller enterprises constitute a significant proportion of the economy, accounting for 71.9% of employed workers and 99.5% of all business establishments in the manufacturing sector in 1980.1 In the context of past industrial policy, smaller enterprises were regarded as the weak link in Japan's economic structure, and the big disparity in productivity between them and large-scale enterprises inspired the term "dual structure" to describe the economy. Today, however, smaller enterprises are referred to as the "vital majority" and, because of their maneuverability and flexibility, have come to play a significant role in the economy. They have become competitive factors and their importance is likely to continue to increase in the future, especially as they contribute

The American journal of managed care, 2016

Unwarranted geographic variation in spending has received intense scrutiny in the United States. ... more Unwarranted geographic variation in spending has received intense scrutiny in the United States. However, few studies have compared variation in spending and surgical outcomes between the United States healthcare system and those of other nations. In this study, we compare the geographic variation in postsurgical outcomes and cost between the United States and Japan. This retrospective cohort study uses Medicare Part A data from the United States (2010-2011) and similar inpatient data from Japan (2012). Patients 65 years or older undergoing 1 of 5 surgeries (coronary artery bypass graft, abdominal aortic aneurysm repair, colectomy, pancreatectomy, or gastrectomy) were selected in the United States and Japan. Reliability- and case-mix-adjusted coefficient of variation (COV) values were calculated using hierarchical modeling and empirical Bayes techniques for the following 5 outcomes: postoperative mortality, the development of a complication, death after complication (failure to resc...