[Abstract] [Full Text HTML] [Full Text PDF] (in Japanese / 415KB)

J.Jpn. Surg. Soc.. 115(1): 8-12, 2014


Feature topic

EVOLUTION AND FUTURE OF THE NATIONAL CLINICAL DATABASE: FEEDBACK FOR SURGICAL QUALITY IMPROVEMENT

1) Division of Surgery, Fukushima Medical University
2) Department of Healthcare Quality Assessment, University of Tokyo Postgraduate School of Medicine
3) Second Department of Surgery, Hamamatsu University School of Medicine
4) Department of Surgery, Osaka University Graduate School of Medicine
5) National Clinical Database
6) Member of the Japanese Society of Gastroenterological Surgery Database Committee

Mitsukazu Gotoh1)5)6), Hiroaki Miyata2)5)6), Hiroyuki Konno3)5)6), Masaki Mori4)5)

The National Clinical Database (NCD) was founded in April 2010 as the parent body of a database linked to the surgical board certification system. Registration began in 2011, and to date more than 3,900 facilities have enrolled, with an accumulation of more than 1.02 million cases per year. Related activities will primarily focus on providing high-quality healthcare to patients and the general public, with the clinical setting serving as the driving force behind improvements. Clinical research using the database and evidence-based policy recommendations will impact businesses, the government, and insurers. In the gastroenterological surgery section, 120,000 cases have accumulated with items representing surgical performance in each specialty for eight procedures: esophagectomy; partial and total gastrectomy; right hemicolectomy; low anterior resection; hepatectomy; pancreatoduodenectomy; and surgery for acute diffuse peritonitis. Risk models have been created for the mortality and morbidity of each procedure. These models will be available for participating hospitals and may be useful for decision making by surgeons as well as patient counseling. Studies are in progress using the NCD database to contribute to improving the quality control of surgical procedures.


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