Impact of financial incentives for inter-provider care coordination on health-care resource utilization among elderly acute stroke patients.

<bold>Objective: </bold>To examine the impact of inter-provider care coordination on health-care resource utilization among elderly acute stroke patients.<bold>Design: </bold>A retrospective cohort study using health-care insurance claims data.<bold>Setting: </bold>Claims data of the Fukuoka Prefecture Wide-Area Association of Latter-Stage Elderly Healthcare.<bold>Participants: </bold>About, 6409 patients aged 75 years or older admitted for acute stroke and moved to rehabilitation wards from 1 April 2010 to 30 September 2015.<bold>Main Outcome Measure: </bold>Lengths of stay (LOS) and total charge (TC) were evaluated according to three groups of care pathways (coordinated care, integrated care and other pathways).<bold>Results: </bold>Compared with the other care pathway, the coordinated care groups had significantly shorter LOS of 2.0 days in acute ischemic stroke care; they had 2.5 days shorter LOS in hemorrhagic stroke care. However, there were no significant differences in rehabilitation care LOS and TC.<bold>Conclusions: </bold>Our findings suggest that a payment system for care coordination is inappropriate since it was not associated with a reduction in overall health-care resource utilization. Further, health-care system reform is necessary to improve care continuity across multiple health-care institutions in Japan. [ABSTRACT FROM AUTHOR]