Background
Methods
Data source
Participants and variables
Statistical analysis
Results
Patient and hospital characteristics
Variables | Fiscal year | Proportion (2012) | Proportion (2016) | Rate of increase (2016 vs. 2012) | ||||
---|---|---|---|---|---|---|---|---|
2012 | 2013 | 2014 | 2015 | 2016 | ||||
Patients | 3989 | 5352 | 8358 | 11,408 | 17,064 | 428% | ||
Consultation-Liaison Psychiatry | ||||||||
Overall | 11,800 | 17,807 | 26,283 | 35,084 | 47,912 | 406% | ||
Per patient (mean, SD) | 2.96 (2.73) | 3.33 (3.64) | 3.14 (3.14) | 3.08 (3.15) | 2.81 (2.75) | – | ||
Per patient (median, interquartile range) | 2 [1–4] | 2 [1–4] | 2 [1–4] | 2 [1–4] | 2 [1–3] | – | ||
Per patient (range) | 1–29 | 1–67 | 1–40 | 1–48 | 1–80 | |||
Coefficient of variation | 0.92 | 1.10 | 1.00 | 1.03 | 0.98 | – | ||
Hospitals | 30 | 34 | 42 | 51 | 109 | 363% | ||
Age group | ||||||||
0–29 | 164 | 231 | 327 | 479 | 662 | 4.1% | 3.9% | |
30–49 | 542 | 796 | 1193 | 1299 | 2019 | 13.6% | 11.8% | |
50–64 | 721 | 1013 | 1431 | 1795 | 2556 | 18.1% | 15.0% | |
65–74 | 778 | 1127 | 1746 | 2536 | 3527 | 19.5% | 20.7% | |
75–84 | 1168 | 1391 | 2386 | 3279 | 5061 | 29.3% | 29.7% | |
85+ | 616 | 794 | 1275 | 2020 | 3239 | 15.4% | 19.0% | |
Sex | ||||||||
Male | 2026 | 2651 | 4290 | 6023 | 9015 | 50.8% | 52.8% | |
Female | 1963 | 2701 | 4068 | 5385 | 8049 | 49.2% | 47.2% | |
Admission setting | ||||||||
Planned | 1451 | 1887 | 3023 | 4051 | 5497 | 36.4% | 32.2% | |
Unplanned or Urgent | 2538 | 3465 | 5335 | 7357 | 11,567 | 63.6% | 67.8% | |
Discharge setting | ||||||||
Outpatients follow up | 2413 | 3209 | 4730 | 6255 | 9100 | 60.5% | 53.3% | |
Transfer to other hospitals | 966 | 1311 | 2231 | 3334 | 5238 | 24.2% | 30.7% | |
Transfer to other welfare facilities | 139 | 173 | 486 | 611 | 876 | 3.5% | 5.1% | |
Others | 471 | 659 | 911 | 1208 | 1850 | 11.8% | 10.8% | |
Discharge outcome | ||||||||
Treated | 3177 | 4331 | 6709 | 9370 | 14,025 | 79.6% | 82.2% | |
Unchanged or worsened | 358 | 333 | 671 | 789 | 1124 | 9.0% | 6.6% | |
Death | 385 | 539 | 783 | 985 | 1505 | 9.7% | 8.8% | |
Other | 69 | 149 | 195 | 264 | 410 | 1.7% | 2.4% | |
Length of stay | ||||||||
2–17 days | 989 | 1189 | 2294 | 3179 | 4754 | 24.8% | 27.9% | |
18–30 days | 938 | 1269 | 1941 | 2724 | 4330 | 23.5% | 25.4% | |
31–54 days | 1038 | 1315 | 1952 | 2798 | 4211 | 26.0% | 24.7% | |
55 days and over | 1024 | 1579 | 2171 | 2707 | 3769 | 25.7% | 22.1% |
Disease classification | Fiscal year | Proportion of patients (n) in 2012 | Proportion of patients (n) in 2016 | ||||
---|---|---|---|---|---|---|---|
2012 | 2013 | 2014 | 2015 | 2016 | |||
1. Certain infectious and parasitic diseases | 146 | 187 | 345 | 377 | 580 | 3.7% | 3.4% |
2. Neoplasms | 1083 | 1333 | 2036 | 2795 | 3906 | 27.1% | 22.9% |
3. Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism | 70 | 97 | 131 | 166 | 226 | 1.8% | 1.3% |
4. Endocrine, nutritional, and metabolic diseases | 164 | 232 | 320 | 385 | 596 | 4.1% | 3.5% |
5. Mental and behavioral disorders | 65 | 107 | 172 | 181 | 328 | 1.6% | 1.9% |
6. Diseases of the nervous system | 141 | 189 | 325 | 393 | 609 | 3.5% | 3.6% |
7. Diseases of the eye and adnexa | 25 | 26 | 41 | 38 | 71 | 0.6% | 0.4% |
8. Diseases of the ear and mastoid process | 7 | 9 | 36 | 40 | 39 | 0.2% | 0.2% |
9. Diseases of the circulatory system | 614 | 788 | 1264 | 1870 | 2851 | 15.4% | 16.7% |
10. Diseases of the respiratory system | 365 | 493 | 723 | 912 | 1542 | 9.2% | 9.0% |
11. Diseases of the digestive system | 352 | 499 | 782 | 1046 | 1666 | 8.8% | 9.8% |
12. Diseases of the skin and subcutaneous tissue | 59 | 98 | 173 | 194 | 261 | 1.5% | 1.5% |
13. Diseases of the musculoskeletal system and connective tissue | 171 | 302 | 517 | 727 | 1085 | 4.3% | 6.4% |
14. Diseases of the genitourinary system | 168 | 241 | 371 | 552 | 711 | 4.2% | 4.2% |
15. Pregnancy, childbirth, and the puerperium | 52 | 67 | 120 | 131 | 213 | 1.3% | 1.2% |
17. Congenital malformations, deformations, and chromosomal abnormalities | 10 | 13 | 21 | 31 | 40 | 0.3% | 0.2% |
18. Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified | 1 | 2 | 3 | 8 | 6 | 0.0% | 0.0% |
19. Injury, poisoning, and certain other consequences of external causes | 496 | 669 | 978 | 1562 | 2333 | 12.4% | 13.7% |
21. Factors influencing health status and contact with health services | 0 | 0 | 0 | 0 | 1 | 0.0% | 0.0% |
Number of patients | Number of CLP performed | Number of hospitals providing CLP | Number of DPC hospitals | Regional data | CLP services per population | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Fiscal year | Fiscal year | Fiscal year | Fiscal year | Number of prefectures | populations (2016) * | |||||||||
Region | 2012 | 2016 | 2012 | 2016 | 2012 | 2016 | 2016 | overall | CLP in 2012 | CLP in 2016 | overall | 65+ | aging ratio | 2016 |
Hokkaido | 202 | 939 | 673 | 2772 | 1 | 4 | 89 | 1 | 1 | 1 | 5352 | 1602 | 29.9% | 0.52 |
Tohoku | 35 | 641 | 115 | 1879 | 1 | 10 | 109 | 6 | 1 | 5 | 8915 | 2674 | 30.0% | 0.21 |
Kanto | 1008 | 6138 | 3016 | 18,309 | 11 | 35 | 427 | 7 | 3 | 6 | 43,132 | 10,748 | 24.9% | 0.42 |
Chubu | 743 | 1512 | 2209 | 4175 | 4 | 19 | 274 | 9 | 3 | 6 | 21,415 | 5922 | 27.7% | 0.19 |
Kinki | 1100 | 4561 | 3185 | 12,038 | 8 | 22 | 325 | 7 | 2 | 4 | 22,489 | 6203 | 27.6% | 0.54 |
Chugoku | 268 | 774 | 900 | 2007 | 3 | 6 | 116 | 5 | 2 | 4 | 7406 | 2218 | 29.9% | 0.27 |
Shikoku | 411 | 925 | 4 | 64 | 4 | 0 | 3 | 3818 | 1209 | 31.7% | 0.24 | |||
Kyushu-Okinawa | 633 | 2088 | 1702 | 5807 | 2 | 9 | 262 | 8 | 2 | 4 | 14,405 | 4014 | 27.9% | 0.40 |
Total | 3989 | 17,064 | 11,800 | 47,912 | 30 | 109 | 1666 | 47 | 14 | 33 | 126,933 | 34,591 | 27.3% | 0.38 |
Variables | Hokkaido | Tohoku | Kanto | Chubu | Kinki | Chugoku | Shikoku | Kyushu-Okinawa | p value | Cramer’s V |
---|---|---|---|---|---|---|---|---|---|---|
N | 939 | 641 | 6138 | 1512 | 4561 | 774 | 411 | 2088 | ||
Age group (%) | < 0.001 | 0.097 | ||||||||
0–29 | 42 (4.5) | 12 (1.9) | 291 (4.7) | 41 (2.7) | 128 (2.8) | 16 (2.1) | 5 (1.2) | 127 (6.1) | ||
30–49 | 116 (12.4) | 45 (7.0) | 873 (14.2) | 149 (9.9) | 417 (9.1) | 76 (9.8) | 37 (9.0) | 306 (14.7) | ||
50–64 | 159 (16.9) | 77 (12.0) | 1070 (17.4) | 191 (12.6) | 522 (11.4) | 98 (12.7) | 61 (14.8) | 378 (18.1) | ||
65–74 | 228 (24.3) | 103 (16.1) | 1275 (20.8) | 274 (18.1) | 942 (20.7) | 153 (19.8) | 87 (21.2) | 465 (22.3) | ||
75–84 | 283 (30.1) | 212 (33.1) | 1724 (28.1) | 480 (31.7) | 1469 (32.2) | 260 (33.6) | 128 (31.1) | 505 (24.2) | ||
85+ | 111 (11.8) | 192 (30.0) | 905 (14.7) | 377 (24.9) | 1083 (23.7) | 171 (22.1) | 93 (22.6) | 307 (14.7) | ||
Sex (%) | 0.009 | 0.032 | ||||||||
Male | 506 (53.9) | 329 (51.3) | 3346 (54.5) | 784 (51.9) | 2327 (51.0) | 394 (50.9) | 234 (56.9) | 1095 (52.4) | ||
Female | 433 (46.1) | 312 (48.7) | 2792 (45.5) | 728 (48.1) | 2234 (49.0) | 380 (49.1) | 177 (43.1) | 993 (47.6) | ||
Admission setting (%) | < 0.001 | 0.163 | ||||||||
Planned | 442 (47.1) | 100 (15.6) | 2157 (35.1) | 336 (22.2) | 1445 (31.7) | 253 (32.7) | 66 (16.1) | 698 (33.4) | ||
Unplanned or Urgent | 497 (52.9) | 541 (84.4) | 3981 (64.9) | 1176 (77.8) | 3116 (68.3) | 521 (67.3) | 345 (83.9) | 1390 (66.6) | ||
Discharge setting (%) | < 0.001 | 0.127 | ||||||||
Outpatients follow up | 600 (63.9) | 302 (47.1) | 3648 (59.4) | 746 (49.3) | 2390 (52.4) | 363 (46.9) | 133 (32.4) | 918 (44.0) | ||
Transfer to other hospitals | 248 (26.4) | 203 (31.7) | 1586 (25.8) | 449 (29.7) | 1324 (29.0) | 278 (35.9) | 232 (56.4) | 918 (44.0) | ||
Transfer to other welfare facilities | 15 (1.6) | 61 (9.5) | 247 (4.0) | 137 (9.1) | 277 (6.1) | 33 (4.3) | 22 (5.4) | 84 (4.0) | ||
Others | 76 (8.1) | 75 (11.7) | 657 (10.7) | 180 (11.9) | 570 (12.5) | 100 (12.9) | 24 (5.8) | 168 (8.0) | ||
Discharge outcome | < 0.001 | 0.077 | ||||||||
Treated | 812 (86.5) | 539 (84.1) | 4817 (78.5) | 1242 (82.1) | 3824 (83.8) | 639 (82.6) | 373 (90.8) | 1779 (85.2) | ||
Unchanged or worsened | 35 (3.7) | 34 (5.3) | 555 (9.0) | 95 (6.3) | 239 (5.2) | 46 (5.9) | 15 (3.6) | 105 (5.0) | ||
Death | 69 (7.3) | 68 (10.6) | 568 (9.3) | 153 (10.1) | 399 (8.7) | 85 (11.0) | 23 (5.6) | 140 (6.7) | ||
Other | 23 (2.4) | 0 (0.0) | 198 (3.2) | 22 (1.5) | 99 (2.2) | 4 (0.5) | 0 (0.0) | 64 (3.1) | ||
Length of stay | < 0.001 | 0.044 | ||||||||
2–17 days | 297 (31.6) | 134 (20.9) | 1650 (26.9) | 358 (23.7) | 1380 (30.3) | 205 (26.5) | 119 (29.0) | 611 (29.3) | ||
18–30 days | 233 (24.8) | 150 (23.4) | 1452 (23.7) | 397 (26.3) | 1217 (26.7) | 220 (25.8) | 125 (30.4) | 556 (26.6) | ||
31–54 days | 189 (20.1) | 173 (27.0) | 1539 (25.1) | 409 (27.1) | 1093 (24.0) | 221 (28.6) | 87 (21.1) | 500 (23.9) | ||
55 days and over | 220 (23.4) | 184 (28.7) | 1497 (24.4) | 348 (23.0) | 871 (19.1) | 148 (19.1) | 80 (19.5) | 421 (20.2) | ||
Consultation-Liaison Psychiatry per patient (mean (sd)) | 2.95 (2.83) | 2.93 (2.63) | 2.98 (2.89) | 2.76 (2.46) | 2.64 (2.54) | 2.59 (2.25) | 2.25 (1.90) | 2.78 (3.22) | < 0.001 |
Variables | Hokkaido | Tohoku | Kanto | Chubu | Kinki | Chugoku | Shikoku | Kyushu-Okinawa | p value | Cramer’s V |
---|---|---|---|---|---|---|---|---|---|---|
N | 939 | 641 | 6138 | 1512 | 4561 | 774 | 411 | 2088 | ||
Disease classification | < 0.001 | 0.078 | ||||||||
1. Certain infectious and parasitic diseases | 33 (3.5) | 18 (2.8) | 230 (3.7) | 46 (3.0) | 157 (3.4) | 16 (2.1) | 10 (2.4) | 70 (3.4) | ||
2. Neoplasms | 240 (25.6) | 104 (16.2) | 1393 (22.7) | 302 (20.0) | 1060 (23.2) | 234 (30.2) | 59 (4.4) | 514 (24.6) | ||
3. Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism | 19 (2.0) | 9 (1.4) | 84 (1.4) | 15 (1.0) | 68 (1.5) | 7 (0.9) | 4 (1.0) | 20 (1.0) | ||
4. Endocrine, nutritional, and metabolic diseases | 30 (3.2) | 18 (2.8) | 216 (3.5) | 59 (3.9) | 160 (3.5) | 17 (2.2) | 12 (2.9) | 84 (4.0) | ||
5. Mental and behavioral disorders | 13 (1.4) | 11 (1.7) | 107 (1.7) | 35 (2.3) | 72 (1.6) | 23 (3.0) | 8 (1.9) | 59 (2.8) | ||
6. Diseases of the nervous system | 44 (4.7) | 13 (2.0) | 238 (3.9) | 52 (3.4) | 133 (2.9) | 34 (4.4) | 12 (2.9) | 83 (4.0) | ||
7. Diseases of the eye and adnexa | 10 (1.1) | 3 (0.5) | 20 (0.3) | 14 (0.9) | 8 (0.2) | 3 (0.4) | 0 (0.0) | 13 (0.6) | ||
8. Diseases of the ear and mastoid process | 2 (0.2) | 3 (0.5) | 26 (0.4) | 3 (0.2) | 2 (0.0) | 0 (0.0) | 0 (0.0) | 3 (0.1) | ||
9. Diseases of the circulatory system | 191 (20.3) | 125 (19.5) | 1219 (19.9) | 230 (15.2) | 710 (15.6) | 119 (15.4) | 67 (16.3) | 190 (9.1) | ||
10. Diseases of the respiratory system | 58 (6.2) | 72 (11.2) | 502 (8.2) | 185 (12.2) | 426 (9.3) | 59 (7.6) | 78 (19.0) | 162 (7.8) | ||
11. Diseases of the digestive system | 72 (7.7) | 70 (10.9) | 557 (9.1) | 147 (9.7) | 480 (10.5) | 81 (10.5) | 37 (9.0) | 222 (0.6) | ||
12. Diseases of the skin and subcutaneous tissue | 12 (1.3) | 8 (1.2) | 83 (1.4) | 33 (2.2) | 64 (1.4) | 19 (2.5) | 4 (1.0) | 38 (1.8) | ||
13. Diseases of the musculoskeletal system and connective tissue | 56 (6.0) | 27 (4.2) | 439 (7.2) | 72 (4.8) | 338 (7.4) | 29 (3.7) | 16 (3.9) | 108 (5.2) | ||
14. Diseases of the genitourinary system | 41 (4.4) | 28 (4.4) | 229 (3.7) | 77 (5.1) | 217 (4.8) | 24 (3.1) | 13 (3.2) | 82 (3.9) | ||
15. Pregnancy, childbirth, and the puerperium | 15 (1.6) | 8 (1.2) | 67 (1.1) | 18 (1.2) | 40 (0.9) | 2 (0.3) | 1 (0.2) | 62 (3.0) | ||
17. Congenital malformations, deformations, and chromosomal abnormalities | 3 (0.3) | 1 (0.2) | 22 (0.4) | 2 (0.1) | 4 (0.1) | 4 (0.5) | 2 (0.5) | 2 (0.1) | ||
18. Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified | 0 (0.0) | 0 (0.0) | 2 (0.0) | 0 (0.0) | 2 (0.0) | 0 (0.0) | 1 (0.2) | 1 (0.0) | ||
19. Injury, poisoning, and certain other consequences of external causes | 100 (10.6) | 123 (19.2) | 704 (11.5) | 222 (14.7) | 620 (13.6) | 103 13.3) | 87 (21.2) | 374 (17.9) | ||
21. Factors influencing health status and contact with health services | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (0.0) |
Variable | β | p value | VIF |
---|---|---|---|
Region (reference: Hokkaido) | 1.012 | ||
Tohoku | −0.220 | 0.034 | |
Kanto | −0.075 | 0.192 | |
Chubu | −0.071 | 0.279 | |
Kinki | 0.009 | 0.882 | |
Chugoku | −0.160 | 0.026 | |
Shikoku | −0.555 | < 0.001 | |
Kyusyu-Okinawa | −0.121 | 0.055 | |
Age group (reference: 85+) | 1.027 | ||
0–29 | 0.410 | < 0.001 | |
30–49 | 0.263 | < 0.001 | |
50–64 | 0.256 | < 0.001 | |
65–74 | 0.144 | < 0.001 | |
75–84 | 0.016 | < 0.001 | |
Sex (reference: Male) | 1.030 | ||
Female | 0.048 | 0.011 | |
Admission setting (reference; planed) | 1.154 | ||
Unplanned | −0.021 | 0.044 | |
Disease classification (reference: 9.Diseases of the circulatory system) | 1.014 | ||
1.Certain infectious and parasitic diseases | 0.315 | < 0.001 | |
2.Neoplasms | 0.098 | 0.018 | |
3.Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism | 0.298 | 0.004 | |
4.Endocrine, nutritional, and metabolic diseases | −0.025 | 0.722 | |
5.Mental and behavioral disorders | −1.016 | < 0.001 | |
6.Diseases of the nervous system | 0.076 | 0.283 | |
7.Diseases of the eye and adnexa | −0.127 | 0.498 | |
8.Diseases of the ear and mastoid process | −0.287 | 0.212 | |
10.Diseases of the respiratory system | 0.133 | 0.010 | |
11.Diseases of the digestive system | 0.088 | 0.079 | |
12.Diseases of the skin and subcutaneous tissue | 0.118 | 0.225 | |
13.Diseases of the musculoskeletal system and connective tissue | 0.290 | < 0.001 | |
14.Diseases of the genitourinary system | −0.007 | 0.912 | |
15.Pregnancy, childbirth, and the puerperium | −0.295 | 0.012 | |
17.Congenital malformations, deformations, and chromosomal abnormalities | −0.121 | 0.622 | |
18.Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified | 0.053 | 0.927 | |
19.Injury, poisoning, and certain other consequences of external causes | 0.125 | 0.006 | |
21.Factors influencing health status and contact with health services | −0.392 | 0.880 | |
Fiscal year (reference; 2012) | 1.010 | ||
2013 | 0.226 | < 0.001 | |
2014 | 0.235 | < 0.001 | |
2015 | 0.233 | < 0.001 | |
2016 | 0.039 | 0.398 | |
Length of Stay (reference; 2–17 days) | 1.015 | ||
18–30 days | 0.111 | < 0.001 | |
31–54 days | 0.246 | < 0.001 | |
55 days and over | 0.587 | < 0.001 | |
Adjusted R-squared | 0.274 |