Association between recorded medical diagnoses and incidence of long-term care needs certification: a case control study using linked medical and long-term care data in two Japanese cities

Iwagami, Masao; Taniguchi, Yuta; Jin, Xueying; Adomi, Motohiko; Mori, Takahiro; Hamada, Shota; Shinozaki, Tomohiro; Suzuki, Mamoru; Uda, Kazuaki; Ueshima, Hiroaki; Iijima, Katsuya; Yoshie, Satoru; Ishizaki, Tatsuro; Ito, Tomoko; Tamiya, Nanako

doi:10.37737/ace.1.2_56

Cited by 15 publications

(20 citation statements)

References 17 publications

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“…We did not detect an association between cancer and LTC (aOR 0.94, 95% CI 0.54–1.63, Table 3 ) unlike previous studies [ 7 , 9 , 22 ]. As patients with ADL deteriorations due to cancer progression may survive and receive LTC for a relatively short time, their data may not have been captured owing to the cross-sectional survey design.…”

Section: Discussioncontrasting

confidence: 99%

“…Regular hospital visits for dementia (aOR 14.62), stroke (aOR 6.90), Parkinson’s disease (aOR 4.37), COPD (aOR 3.44), fracture (aOR 2.96), rheumatoid arthritis (aOR 2.66), kidney diseases (aOR 2.16), diabetes (aOR 1.60) and osteoporosis (aOR 1.37), difficulty in limb movement (aOR 2.07) and incontinence (aOR 1.61), were among those significantly associated with LTC certification in the multivariate analyses (Table 3 ), consistent with previous studies [ 7 , 9 , 14 , 16 ]. Regular hospital visits for COPD showed strikingly high ORs (aOR 3.44), even though ‘respiratory diseases’ including COPD among others ranked only 10th as a cause of LTC in 2013 [ 10 ].…”

Section: Discussionsupporting

confidence: 89%

“…The physical and clinical factors associated with LTC have been investigated extensively. Studies using medical and LTC claims data in Japan and Germany identified chronic conditions associated with LTC certification, including fractures, dementia, pneumonia, strokes, Parkinson’s disease, diabetes and arthropathy [ 7 – 9 ]. According to the Comprehensive Survey of Living Conditions (CSLC) in Japan, the major causes of LTC certification are stroke, dementia and infirmity to ageing [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with long-term care certification in older adults: a cross-sectional study based on a nationally representative survey in Japan

et al. 2021

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Background Long-term care (LTC) prevention is a pressing concern in ageing societies. To understand the risk factors of LTC, it is vital to consider psychological and social factors in addition to physical factors. Owing to a lack of relevant data, we aimed to investigate the social, physical and psychological factors associated with LTC using large-scale, nationally representative data to identify a high-risk population for LTC in terms of multidimensional frailty. Methods We performed a cross-sectional study using anonymised data from the 2013 Comprehensive Survey of Living Conditions conducted by the Ministry of Health, Labour and Welfare of Japan. Among the 23,730 eligible people aged 65 years or older and those who were not in hospitals or care facilities during the survey, 1718 stated that they had LTC certification. Univariate and multivariate logistic regression analyses were performed to determine the factors associated with LTC certification. Results Factors positively associated with LTC certification in the multivariate analyses included older age, the interaction term between sex and age group at age 85–89 years, limb movement difficulties, swollen/heavy feet, incontinence, severe psychological distress (indicated by a Kessler Psychological Distress Scale [K6] score ≥ 13), regular hospital visits for dementia, stroke, Parkinson’s disease, chronic obstructive pulmonary disease, fracture, rheumatoid arthritis, kidney disease, diabetes and osteoporosis. Factors negatively associated with LTC certification included the presence of a spouse, regular hospital visits for hypertension and consulting with friends or acquaintances about worries and stress. Conclusions In summary, we identified the physical, psychological and social factors associated with LTC certification using nationally representative data. Our findings highlight the importance of the establishment of multidimensional approaches for LTC prevention in older adults.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Factors associated with long-term care certification in older adults: a cross-sectional study based on a nationally representative survey in Japan

et al. 2021

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“…These diseases were selected because they were the dominant causes for long-term care requirements [ 1 ]. The ICD-10 codes in the medical claims data, three months prior to the baseline, were used to identify each disease as follows: cerebrovascular diseases were defined as I60–I69; cardiac diseases were defined as I20–I25, I40, I45, and I47–I49; fractures were defined as S27, S02, S12, S22, S32, S42, S52, S62, S82, S92, T02, T08, T02, T08, T10, and T12; and joint diseases were defined as M05, M06, M00–M03, M07, and M10–M25 [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

Factors Affecting Care-Level Deterioration among Older Adults with Mild and Moderate Disabilities in Japan: Evidence from the Nationally Standardized Survey for Care-Needs Certification

Suzuki

Jin

Ito

et al. 2022

IJERPH

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This study aims to investigate the factors of care-level deterioration in older adults with mild and moderate disabilities using nationally standardized survey data for care-needs certification. We enrolled people aged 68 years or older, certified as support levels 1–2 (mild disability) or care levels 1–2 (moderate disability) with no cancer. The outcome was care-level deterioration after two years. The possible factors were physical and mental functions which were categorized as the following five dimensions according to the survey for care-needs certification: body function, daily life function, instrumental activities of daily living (IADL) function, cognitive function, and behavioral problems. A multivariate logistic regression analysis was conducted after stratifying the care level at baseline. A total of 2844 participants were included in our analysis. A low IADL function was significantly associated with a risk of care-level deterioration in all participants. In addition, low cognitive function was linked to care-level deterioration, except for those with support level 1 at baseline. Participants with more behavioral problems were more likely to experience care-level deterioration, except for those with care level 2 at baseline. Our study showed the potential utility of the care-needs certification survey for screening high-risk individuals with care-level deterioration.

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“…This individual linked dataset was used in some previous studies. [17][18][19][20] The data was provided by Kashiwa City to the University of Tsukuba for research purposes, and the data provided and used for research purposes was approved by the Medical Ethical Review Board of University of Tsukuba (approved number 1448).…”

Section: Study Design and Data Collectionmentioning

confidence: 99%

Prevention Services via Public Long-term Care Insurance can be Effective Among a Specific Group of Older Adults: A City Claim Data Analysis

Ito

Mori

Shimafuji³

et al. 2020

Preprint

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BackgroundTo evaluate the effects of prevention services provided by long-term care insurance (LTCI) for older adults who require support from LTCI in Kashiwa City, Japan MethodsWe conducted an analysis using the following population-based longitudinal data in Kashiwa City between April 2012 and March 2015: Data of National Health Insurance and LTCI claims, the survey for certification of LTCI, the register, and premium tier classification. All data was linked using the pre-assigned anonymous identifying numbers. We analyzed the Cox regression model using the time for the deteriorations of long-term care levels as an outcome and the use of preventive care services as the primary exposure among participants aged 75 years or older, who had either support levels 1 or 2 at the beginning of this analysis. The study was further stratified by both age and initial support level. ResultsThe final analysis included 1,289 participants. The primary result showed, among all participants, that preventive service was not effective (hazard ratio 0.96, 95% confidence interval 0.78-1.19). In our sub-analysis, the preventive service was effective in avoiding deteriorations only among those aged 85 and older with support level 1 (HR 0.65, 95% CI 0.43-0.97) out of four groups.ConclusionsThe preventive services of LTCI in Kashiwa City showed a significant effect on the deterioration among subjects aged 85 or older, whose disabled level were low (support level 1). Our results suggest that the prevention services provided by LTCI may not be effective for all older individuals; to provide these services efficiently, local governments, as insurers of LTCI, will need to identify the specified groups that may benefit from the preventive services.

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Association between recorded medical diagnoses and incidence of long-term care needs certification: a case control study using linked medical and long-term care data in two Japanese cities

Cited by 15 publications

References 17 publications

Factors associated with long-term care certification in older adults: a cross-sectional study based on a nationally representative survey in Japan

Factors associated with long-term care certification in older adults: a cross-sectional study based on a nationally representative survey in Japan

Factors Affecting Care-Level Deterioration among Older Adults with Mild and Moderate Disabilities in Japan: Evidence from the Nationally Standardized Survey for Care-Needs Certification

Prevention Services via Public Long-term Care Insurance can be Effective Among a Specific Group of Older Adults: A City Claim Data Analysis

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