{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:47:55Z","timestamp":1784270875896,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T00:00:00Z","timestamp":1729036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["JPMH21IA1005"],"award-info":[{"award-number":["JPMH21IA1005"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["JPMH24AA2006"],"award-info":[{"award-number":["JPMH24AA2006"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP23H00448"],"award-info":[{"award-number":["JP23H00448"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the early effects of the financial incentive (FI) implemented in April 2022 in Japan for surgeries within 48\u2009h after hip fracture (HF) in patients aged 75 and older on expedited HF surgery (EHFS), in\u2010hospital mortality, perioperative morbidity, length of stay (LOS) and inpatient medical expenses (IMEs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Setting and Design<\/jats:title><jats:p>We conducted a quasi\u2010experimental study and constructed segmented regression models for controlled interrupted time\u2010series analyses, assuming a Poisson distribution, to evaluate the slope changes (SCs) in the outcomes of interest before and after the introduction of the FI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources and Analytic Sample<\/jats:title><jats:p>We used Diagnosis Procedure Combination data from the Quality Indicator\/Improvement Project database between 1 April 2018 and 31 March 2023. Patients aged 50 years or older who were hospitalized with a diagnosis of HF and underwent surgery for HF were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>A total of 82,163 patients from 183 hospitals were included in the analyses. In the age group of 75 years and older, increasing trends in the number of EHFSs were observed even before the introduction of the FI, while before and after the introduction of the FI, none of the SCs in the monthly number of EHFSs within 2 days, within 1 day, and on the day of admission were statistically significant (incident rate ratio: 1.0043, 95% confidence interval [CI]: [0.9977\u20131.0111], 1.0068 [0.9987\u20131.0149], 1.0073 [0.9930\u20131.0219]). Nor were any of the SCs in in\u2010hospital deaths, perioperative complications, LOS, and IMEs statistically significant. Additionally, there were no statistical differences in the SCs for any of the outcomes between the two age groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study suggested that there was no significant, short\u2010term effect of the FI for surgeries within 48\u2009h after HF on any of the outcomes of interest.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.14189","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T06:25:19Z","timestamp":1729146319000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Early effect of a financial incentive for surgeries within 48\u2009h after hip fracture on the number of expedited hip fracture surgeries, in\u2010hospital mortality, perioperative morbidity, length of stay and inpatient medical expenses"],"prefix":"10.1111","volume":"31","author":[{"given":"Kenta","family":"Minato","sequence":"first","affiliation":[{"name":"Department of Healthcare Economics and Quality Management, Graduate School of Medicine Kyoto University Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susumu","family":"Kunisawa","sequence":"additional","affiliation":[{"name":"Department of Healthcare Economics and Quality Management, Graduate School of Medicine Kyoto University Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4613-2159","authenticated-orcid":false,"given":"Yuichi","family":"Imanaka","sequence":"additional","affiliation":[{"name":"Department of Healthcare Economics and Quality Management, Graduate School of Medicine Kyoto University Kyoto Japan"},{"name":"Centre for Health Security, Graduate School of Medicine Kyoto University Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-006-0172-4"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01623184"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-015-3464-8"},{"key":"e_1_2_8_5_1","volume-title":"Clinical Practice Guideline on the Management of Hip Fractures","author":"The Japanese Orthopaedic Association","year":"2021"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2011.05.017"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-015368"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2014.10.051"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.18.2053"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-016-3624-5"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.103B7.BJJ-2020-2582.R1"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-32098-7"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.17606"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.101B9.BJJ-2019-0295.R1"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.01147"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S65736"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.06.007"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2014-003700"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2013.04.012"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2009.11.016"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-13-393"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.101B8.BJJ-2019-0173.R1"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-014190"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004305"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2017.06.003"},{"key":"e_1_2_8_26_1","unstructured":"Ministry of Health Labour and Welfare. 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