Changes in percutaneous coronary intervention practice in Japan during the COVID‐19 outbreak: LIFE Study

Abstract

Aim The global outbreak of coronavirus disease (COVID‐19) has had widespread effects on clinical practice, and is reportedly associated with reduced percutaneous coronary intervention (PCI) rates in the US and Italy. This study aimed to ascertain the influence of the COVID‐19 outbreak on PCI practice in Japan. Methods In a retrospective analysis of claims data from National Health Insurance and Later‐Stage Elderly Healthcare System enrollees in Kobe City, Japan, we examined the changes in PCI incidence before and during the COVID‐19 outbreak. Percutaneous coronary intervention incidence during the COVID‐19 outbreak in 2020 was compared with that of the same (pre‐outbreak) period in 2019 using a Poisson regression analysis with the monthly number of PCIs as the dependent variable. Results A total of 639 patients underwent PCI in Kobe City between February and May 2020. The results showed a 19% reduction in all PCI procedures during the outbreak relative to the pre‐outbreak period (P = 0.001). There were no significant changes in non‐elective PCIs for acute coronary syndrome (ACS) cases, but a 25% reduction in elective PCIs for non‐ACS cases ( P < 0.001). Conclusions The COVID‐19 outbreak was associated with a decline in elective PCIs for non‐ACS cases, but did not appear to influence non‐elective PCIs for ACS cases in Japan.

The Longevity Improvement & Fair Evidence (LIFE) Study: Overview of the Study Design and Baseline Participant Profile

“…This enables medium-to-long term follow-up analyses using various study designs, such as cohort studies and nested casecontrol studies. [9][10][11][12] In 2011, the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) began providing data for research. The NDB encompasses health care claims data and LTC claims data from almost all citizens and long-term residents within Japan, so it has the potential to support a wide variety of population-based research projects.…”

“…In contrast, the LIFE Study can facilitate research that should be released quickly when needed, such as a study on changes in percutaneous coronary intervention practice during the first wave of COVID-19 in Japan. 12 As municipal governments can access health care claims data Profile of the LIFE Study approximately 2 months after health services are provided, the LIFE Study is able to collect data with only a 2-or 3-month time lag. Second, the NDB stipulates that aggregate data with only 1 to 9 cases cannot be published, which can cause gaps in the evidence (eg, when mortality rates cannot be reported for certain groups).…”

“…Figure 2 shows a flowchart of data collection in the LIFE Study. The following data items are collected: (1) health care claims data, (2) LTC claims data, (3) LTC needs certification data, (4) specific health checkups and specific health guidance data, (5) vaccination records, (6) maternal and child health checkup records, (7) cancer screening records, (8) dental checkup records, (9) health services/ LTC prevention services recipient lists, (10) other health care/ LTC/health-related individual data, (11) residence-related information (elementary school district, junior high school district, and area of daily activities), (12) income-related information (outof-pocket payment ceiling amount category under the High-Cost Medical Expense Benefit System and insurance premium category for primary insured persons), and (13) insurance registry data. However, there are inter-municipal variations in the governmental departments assigned to participate in the LIFE Study, resulting in differences in the data items provided by each municipality.…”