Seasonality in the incidence of biliary atresia in Japan.
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Biliary Atresia↗
Biomedical subjects
Shin-Ichi Toyabe
Publications and source records attributed to Shin-Ichi Toyabe.
Development of a practical costing method for hospitals.
To realize an effective cost control, a practical and accurate cost accounting system is indispensable in hospitals. In traditional cost accounting systems, the volume-based costing (VBC) is the most popular cost accounting method. In this method, the indirect costs are allocated to each cost object (services or units of a hospital) using a single indicator named a cost driver (e.g., Labor hours, revenues or the number of patients). However, this method often results in rough and inaccurate results. The activity based costing (ABC) method introduced in the mid 1990s can prove more accurate results. With the ABC method, all events or transactions that cause costs are recognized as "activities", and a specific cost driver is prepared for each activity. Finally, the costs of activities are allocated to cost objects by the corresponding cost driver. However, it is much more complex and costly than other traditional cost accounting methods because the data collection for cost drivers is not always easy. In this study, we developed a simplified ABC (S-ABC) costing method to reduce the workload of ABC costing by reducing the number of cost drivers used in the ABC method. Using the S-ABC method, we estimated the cost of the laboratory tests, and as a result, similarly accurate results were obtained with the ABC method (largest difference was 2.64%). Simultaneously, this new method reduces the seven cost drivers used in the ABC method to four. Moreover, we performed an evaluation using other sample data from physiological laboratory department to certify the effectiveness of this new method. In conclusion, the S-ABC method provides two advantages in comparison to the VBC and ABC methods: (1) it can obtain accurate results, and (2) it is simpler to perform. Once we reduce the number of cost drivers by applying the proposed S-ABC method to the data for the ABC method, we can easily perform the cost accounting using few cost drivers after the second round of costing.
Accounting↗
Development of a simulation program for estimating hospital incomes under the prospective payment system.
A prospective payment system based on diagnosis procedure combination (DPC/PPS) was introduced to acute care hospitals in Japan in April 2003. In order to increase hospital income, hospitals must shorten the average length of stay (ALOS) and increase the number of patients. We constructed a simulation program for evaluating the relationships among ALOS, bed occupation rate (BOR) and hospital income of hospitals in which DPC/PPS has been introduced. This program can precisely evaluate the hospital income by regulating the ALOS and the number of patients for each DPC. By using this program, it is possible to predict the optimum ALOS and optimum number of inpatients for each DPC in order to increase hospital income.
Bed Occupancy↗
CHRONIS: an animal chromosome image database.
We have constructed a database system named CHRONIS (CHROmosome and Nano-Information System) to collect images of animal chromosomes and related nanotechnological information. CHRONIS enables rapid sharing of information on chromosome research among cell biologists and researchers in other fields via the Internet. CHRONIS is also intended to serve as a liaison tool for researchers who work in different centers. The image database contains more than 3,000 color microscopic images, including karyotypic images obtained from more than 1,000 species of animals. Researchers can browse the contents of the database using a usual World Wide Web interface in the following URL: http://chromosome.med.niigata-u.ac.jp/chronis/servlet/chronisservlet. The system enables users to input new images into the database, to locate images of interest by keyword searches, and to display the images with detailed information. CHRONIS has a wide range of applications, such as searching for appropriate probes for fluorescent in situ hybridization, comparing various kinds of microscopic images of a single species, and finding researchers working in the same field of interest.
Animals↗
Impact of sociocultural factors on hospital length of stay in children with nephrotic syndrome in Japan.
Hospital length of stay (LOS) of Japanese inpatients is extraordinarily long, partly because of the nature of the health insurance system in Japan. We investigated factors that affect the LOS in Japan, taking pediatric nephrosis as an example. The characteristics of 78 hospitalized children with steroid-sensitive nephrotic syndrome were studied. The median LOS of the patients was 47 days. Most of the patients' mothers (92.3%) stayed in hospital during admission to care for their children. Using multivariate Cox's regression analysis with time-dependent covariates, non-working mother and smaller number of siblings were found to be factors significantly associated with prolonged LOS. These factors are presumed to allow the mothers to care for their hospitalized children for a long period. No medical or clinical factors played a significant role in the prolonged LOS. These results suggest that sociocultural factors have a greater influence on the LOS in Japan than do medical factors such as disease course, coexisting illness, complications, and treatment response.
Child↗
Actual and estimated costs of disposable materials used during surgical procedures.
It is difficult to estimate precisely the costs of disposable materials used during surgical operations. To evaluate the actual costs of disposable materials, we calculated the actual costs of disposable materials used in 59 operations by taking account of costs of all disposable materials used for each operation. The costs of the disposable materials varied significantly from operation to operation (US$ 38-4230 per operation), and the median [25-percentile and 75-percentile] of the sum total of disposable material costs of a single operation was found to be US$ 686 [205 and 993]. Multiple regression analysis with a stepwise regression method showed that costs of disposable materials significantly correlated only with operation time (p<0.001). Based on the results, we propose a simple method for estimating costs of disposable materials by measuring operation time, and we found that the method gives reliable results. Since costs of disposable materials used during surgical operations are considerable, precise estimation of the costs is essential for hospital cost accounting. Our method should be useful for planning hospital administration strategies.
Cost Allocation↗
Web-based delivery of medical multimedia contents using an MPEG-4 system.
Moving picture expert group compression standard version 4 (MPEG-4) is a standard for video coding aimed at multimedia applications. MPEG-4 was developed to enable high compression rate in a low bitrate transmission via the Internet or mobile telecommunications. Although these characteristics of MPEG-4 are suitable for telemedicine, little is known about the possibility of using this technology in the field of telemedicine. We evaluated the quality of MPEG-4-encoded medical video streams and compared them with original analogue videos and audio-video-interleave (AVI) files. Although MPEG-4 video streams have the advantage of small file size, they were found to be inferior to original videos and AVI files in terms of smoothness of motion pictures, sharpness of images and clearness of sound. Illegibility of characters was a major problem in MPEG-4 files. The score for total impression of MPEG-4 files was significantly lower than those for AVI files. The results of this study suggest that the quality of MPEG-4-encoded video streams is not adequate for telemedicine.
Humans↗
Development and evaluation of a teleradiology and videoconferencing system.
We developed a teleradiology system linking a general hospital on Sado Island to tertiary care hospitals in Niigata City. The island is 40 km from Niigata City on the mainland and has only one diagnostic radiologist (for 72,000 islanders). Fibre optic cables between Sado Island and Niigata City were used for transmission. The introduction of the teleradiology system facilitated diagnostic and therapeutic consultation with specialists in Niigata City. The performance of the system was evaluated (on a scale of 0-6, with higher scores indicating better performance) by five diagnostic radiologists, who rated 32 features of the system twice, once in April 2002 and once in September 2003. The performance ratings improved from 1.38 to 2.86. While many of the initial problems with the software had been resolved, many still remained.
Adult↗