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Evaluation of compliance with the Tokyo Guidelines for the management of acute cholangitis based on the Japanese administrative database associated with the Diagnosis Procedure Combination system

  • Original article
  • Published:
Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Background/purpose

We aimed to evaluate compliance with the clinical practice guidelines for acute cholangitis (Tokyo Guidelines) using the Japanese administrative database associated with the Diagnosis Procedure Combination (DPC) system.

Methods

We collected database data from 60,842 acute cholangitis patients, examining 10 recommendations in the Tokyo Guidelines. We counted how many recommendations had been complied with for every patient. The patient compliance score was defined as the rate of compliance with these recommendations (score 0 = 0% to score 10 = 100%). An aggregated patient compliance score was measured according to the severity of acute cholangitis. Severity was categorized as grade I (mild cholangitis; n = 49,630), grade II (moderate cholangitis; n = 10,444), and grade III (severe cholangitis; n = 768).

Results

The mean patient compliance score was significantly higher for patients with grade III than for those with grades II and I (7.6 ± 2.1 vs. 6.5 ± 3.0 vs. 2.9 ± 0.9, p < 0.001, respectively). Multiple linear regression analysis revealed that the severity of acute cholangitis was the parameter most significantly associated with the patient compliance score. The standardized coefficient of grade III was higher than that of grade II (0.657 vs. 0.248, p < 0.001).

Conclusions

Compliance with the Tokyo Guidelines became higher in accordance with the severity of acute cholangitis.

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Acknowledgments

This study was funded by Grants-in-Aid for Research on Policy Planning and Evaluation from the Ministry of Health, Labour and Welfare, Japan.

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Authors and Affiliations

  1. Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan

    Atsuhiko Murata, Shinya Matsuda, Yoshihisa Fujino & Tatsuhiko Kubo

  2. Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Kazuaki Kuwabara

  3. Division of Medical Management, Hokkaido University Hospital, Hokkaido, Japan

    Kenji Fujimori

  4. Department of Health Management and Policy, Graduate School of Medicine, Tokyo University, Tokyo, Japan

    Hiromasa Horiguchi

Authors
  1. Atsuhiko Murata
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  2. Shinya Matsuda
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  3. Kazuaki Kuwabara
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  4. Yoshihisa Fujino
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  5. Tatsuhiko Kubo
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  6. Kenji Fujimori
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  7. Hiromasa Horiguchi
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Corresponding author

Correspondence to Atsuhiko Murata.

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Cite this article

Murata, A., Matsuda, S., Kuwabara, K. et al. Evaluation of compliance with the Tokyo Guidelines for the management of acute cholangitis based on the Japanese administrative database associated with the Diagnosis Procedure Combination system. J Hepatobiliary Pancreat Sci 18, 53–59 (2011). https://doi.org/10.1007/s00534-010-0302-4

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  • DOI: https://doi.org/10.1007/s00534-010-0302-4

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