Contribution of the long-term care insurance certificate for predicting 1-year all-cause readmission compared with validated risk scores in elderly patients with heart failure

Takahashi, Kei; Saito, Makoto; Inaba, Shinji; Morofuji, Toru; Aisu, Hiroe; Sumimoto, Takumi; Ogimoto, Akiyoshi; Ikeda, Shuntaro; Higaki, Jitsuo

doi:10.1136/openhrt-2016-000501

Cited by 11 publications

(7 citation statements)

References 43 publications

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“…Most patients with HF have to live in their houses after discharge and manage daily living with HF by themselves or have family support. A single‐center study from Ozu City showed that 37% of patients had LTCI 21 . This percentage was also two times higher than those of community‐dwelling people in Japan, which might indicate that patients with HF had a two times higher risk of burden for the LTCI.…”

Section: Discussionmentioning

confidence: 99%

Impact of home‐ and community‐based services in the long‐term care insurance system on outcomes of patients with acute heart failure: Insights from the Kitakawachi Clinical Background and Outcome of Heart Failure Registry

Takabayashi

Fujita

Iwatsu

et al. 2020

Geriatrics Gerontology Int

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In Japan, the long-term care insurance (LTCI) system is important for elderly people living at home; however, no clinical studies have revealed a relationship between home-or community-based services and outcomes in patients with acute heart failure (AHF). Methods: This was a prospective multicenter cohort study of patients with AHF enrolled between April 2015 and August 2017. Patients aged ≥65 years with LTCI were divided into those receiving home-and community-based services (service users) and without home and community-based services (service non-users). The endpoint was defined as a composite endpoint, which included all-cause mortality and hospitalization for heart failure after discharge. Subgroup analyses were performed for elderly patients (<85 years) or super-elderly patients (≥85 years). Results: The study participants were eligible for LTCI two times more than communitydwelling people were. At the 1-year follow-up period, the rate of the composite endpoint showed no significant difference between service users and service non-users among all patients or super-elderly patients. However, in elderly patients, the rate of the composite endpoint was significantly lower among service users than service non-users. The difference was independently maintained even after adjustments for differences in comorbidities or in social backgrounds (adjusted hazard ratio 0.62; 95% confidence interval 0.38-0.99, and adjusted hazard ratio 0.57; 95% confidence interval 0.35-0.90, respectively). Conclusions: In this study, adverse events following discharge of patients with AHF who used home-and community-based services were prevented only in elderly patients, not in super-elderly patients.

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Section: Discussionmentioning

confidence: 99%

Impact of home‐ and community‐based services in the long‐term care insurance system on outcomes of patients with acute heart failure: Insights from the Kitakawachi Clinical Background and Outcome of Heart Failure Registry

Takabayashi

Fujita

Iwatsu

et al. 2020

Geriatrics Gerontology Int

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“…Previous studies have shown some predictors of functional decline after HF [ 7 , 20 – 22 , 24 ]. While those studies examined risk factors for functional disability, their timing of assessment differed from our study, that is, while previous studies were conducted on hospital admission and/or at discharge, we gathered information on risk factors in subjects initially free of diseases and identified etiologic precursors by following up for 11 years.…”

Section: Discussionmentioning

confidence: 99%

“…Existing research has assessed socioeconomic status and cardiovascular risk factors at the time of hospital admission for HF. In particular, studies have focused on cardiac function after HF, for example, ejection fraction and valvular diseases [ 24 , 29 ]. In the present study, we assessed baseline risk factors obtained several years before HF onset.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have identified risk factors for the development of disability in patients with HF [ 7 , 21 , 23 ]. One Japanese study showed that functional disability assessed by LTCI is related to a high readmission rate after HF [ 24 ]. However, these studies evaluated individual characteristics, such as ejection fraction, as prognosis factors.…”

Section: Introductionmentioning

confidence: 99%

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Low educational level increases functional disability risk subsequent to heart failure in Japan: On behalf of the Iwate KENCO study group

et al. 2021

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Objectives The risk factors that contribute to future functional disability after heart failure (HF) are poorly understood. The aim of this study was to determine potential risk factors to future functional disability after HF in the general older adult population in Japan. Methods The subjects who were community-dwelling older adults aged 65 or older without a history of cardiovascular diseases and functional disability were followed in this prospective study for 11 years. Two case groups were determined from the 4,644 subjects: no long-term care insurance (LTCI) after HF (n = 52) and LTCI after HF (n = 44). We selected the controls by randomly matching each case of HF with three of the remaining 4,548 subjects who were event-free during the period: those with no LTCI and no HF with age +/-1 years and of the same sex, control for the no LTCI after HF group (n = 156), and control for the LTCI after HF group (n = 132). HF was diagnosed according to the Framingham diagnostic criteria. Individuals with a functional disability were those who had been newly certified by the LTCI during the observation period. Objective data including blood samples and several socioeconomic items in the baseline survey were assessed using a self-reported questionnaire. Results Significantly associated risk factors were lower educational levels (odds ratio (OR) [95% confidence interval (CI)]: 3.72 [1.63–8.48]) in the LTCI after HF group and hypertension (2.20 [1.10–4.43]) in no LTCI after HF group. Regular alcohol consumption and unmarried status were marginally significantly associated with LTCI after HF (OR [95% CI]; drinker = 2.69 [0.95–7.66]; P = 0.063; unmarried status = 2.54 [0.91–7.15]; P = 0.076). Conclusion Preventive measures must be taken to protect older adults with unfavorable social factors from disability after HF via a multidisciplinary approach.

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“…This poses significant problems, including prognosis, impaired quality of life and increased costs and resource use 1–4. Also, ageing patients with HF are increasingly common in an ultra-ageing society, and the majority of them are frail and suffer from multiple chronic comorbidities 5–10. These patients require readmissions due to worsening HF and other comorbidities 2…”

Section: Introductionmentioning

confidence: 99%

Impact of residence altitude on readmission in patients with heart failure

Saito¹,

Yamaoka²,

Ohzawa³

et al. 2018

Open Heart

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ObjectiveMountain districts normally have tougher geographic conditions than plain districts, which might worsen heart failure (HF) conditions in patients. Also, those places frequently are associated with social problems of ageing, underpopulation and fewer medical services, which might cause delay in detection of disease progression and require more admissions. We investigated the association of residence altitude with readmission in patients with HF.MethodsWe followed 452 patients with HF to determine all-cause readmissions over a median of 1.1 years. The altitude of patient residences, population, proportion of the elderly and number of hospitals or clinics in a minor administrative district (Cho-Aza district) located at the residences were examined using data from the 2010 census and Google Maps.ResultsAll-cause readmissions were observed in 269 (60%) patients. The altitude of ≥200 m was significantly associated with readmissions (HR, 1.49; 95 % CI 1.12 to 1.96; p=0.006) after adjustment for physical and haemodynamic parameters, left ventricular ejection fraction, brain natriuretic peptide and components of the established score for predicting readmission for HF. Altitude was significantly associated with ageing, underpopulation, fewer hospitals or clinics and lower temperature (all p<0.01), with an increased tendency for readmission during the winter season; however, it was not associated with patient clinical parameters.ConclusionsHigh altitude residence may be an important predictor for readmission in patients with HF. This relationship may be confounded by unfavourable sociogeographic conditions at higher altitudes.

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Contribution of the long-term care insurance certificate for predicting 1-year all-cause readmission compared with validated risk scores in elderly patients with heart failure

Cited by 11 publications

References 43 publications

Impact of home‐ and community‐based services in the long‐term care insurance system on outcomes of patients with acute heart failure: Insights from the Kitakawachi Clinical Background and Outcome of Heart Failure Registry

Impact of home‐ and community‐based services in the long‐term care insurance system on outcomes of patients with acute heart failure: Insights from the Kitakawachi Clinical Background and Outcome of Heart Failure Registry

Low educational level increases functional disability risk subsequent to heart failure in Japan: On behalf of the Iwate KENCO study group

Impact of residence altitude on readmission in patients with heart failure

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