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 <scp>Kitakawachi Clinical Background and Outcome of Heart Failure Registry</scp>

Takabayashi, Kensuke; Fujita, Ryoko; Iwatsu, Kotaro; Ikeda, Tsutomu; Morikami, Yasuhiro; Ichinohe, Tahei; Yamamoto, Takashi; Takenaka, Kotoe; Okuda, Miyuki; Nakajima, Osamu; Koito, Hitoshi; Terasaki, Yuka; Kitamura, Tetsuhisa; Kitaguchi, Shouji; Nohara, Ryuji

doi:10.1111/ggi.14013

Cited by 13 publications

(4 citation statements)

References 13 publications

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“…Fifth, HF with supernormal EF has been reported to have a poor prognosis, and care should be taken in interpreting the results of this study, since the prognosis may vary depending on whether the patient is classi ed as supernormal or not, even among patients classi ed as HFpEF [22]. Sixth, nursing home use may in uence the event rate of HF readmission, and, information on social factors, such as information on caregiving, is needed [23]. The possibility that potential confounding factors may in uence prognosis cannot be ruled out, so caution must be exercised in drawing the conclusion that HFpEF has a good prognosis based on the results of this study.…”

Section: Limitationsmentioning

confidence: 91%

Patients with acute decompensated heart failure in an area with a super-aging society; A single- center, retrospective cohort study

Tanabe,

Sasaki,

Okazaki

et al. 2024

Preprint

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Background In recent years, the population of very elderly heart failure (HF) patients has been rising, but there are few reports on their characteristics, treatment, and prognosis. Methods This study included patients aged 18 years or older with acute HF admitted to a single hospital between April 1, 2016, and March 31, 2021. Patients were classified into three groups according to their echocardiographic left ventricular ejection fraction (LVEF): HF with reduced LVEF (LVEF < 40%: HFrEF), HF with mildly reduced LVEF (LVEF between 40% and 49%: HFmrEF), and HF with preserved LVEF (LVEF ≥ 50%: HFpEF). Results Of 524 admitted patients, 437 were discharged, including 124 with HFrEF, 62 with HFmrEF, and 251 with HFpEF. The median age was 86 years, and patients with HFmrEF and HFpEF were older than those with HFrEF. Overall, the in-hospital mortality rate was 14.1%, the 1-year composite event rate of cardiac death and heart failure readmission was 37.7%, and the 1-year all-cause death rate was 19.7%. In particular, the composite event rate was higher in patients with HFrEF than in those with HFpEF (44.0% vs. 32.8%, P = 0.03). Conclusions The high incidence of in-hospital mortality, composite events, and all-cause mortality in this very elderly population warrants prospective consideration of appropriate treatment choices and goal setting for these patients.

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Section: Limitationsmentioning

confidence: 91%

Patients with acute decompensated heart failure in an area with a super-aging society; A single- center, retrospective cohort study

Tanabe,

Sasaki,

Okazaki

et al. 2024

Preprint

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“…Therefore, almost 40% of patients with HF have LTCI, which is twice that reported in community-based studies. 16 According to the prevalence and prognostic value of physical and social frailty in geriatric patients hospitalized for HF (FRAGILE-HF) 17 and Kochi YOSACOI 18 studies, half of the patients with HF have physical frailty, social isolation, and cognitive impairment, and these are independent prognostic risk factors. Therefore, in a super-aging society, Japanese patients with HF face both medical and care-related problems.…”

Section: Medical Doctorsmentioning

confidence: 99%

“…60 among non-users. 16 Possibilities of Remote Monitoring The Home Telemonitoring Study for Japanese Patients with HF (HOMES-HF) was the first multicenter, open-label, randomized controlled trial to elucidate the effectiveness of home telemonitoring of physiological data, such as body weight, blood pressure, and pulse rate. 77 Although the adherence rate of the study participants was maintained at approximately 90% at 2 months, there was no statistically significant difference in the primary endpoint (all-cause death or rehospitalization due to worsening HF) between the groups.…”

Section: Risk Reduction For Cardiac Events and Medicalmentioning

confidence: 99%

Developing Multidisciplinary Management of Heart Failure in the Super-Aging Society of Japan

Sato

Kuragaichi

Nakayama

et al. 2023

Circ J

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National Plan) in October 2020. 5 Although progression of HF is a cause of rehospitalization, as the number of older patients increases, many socioeconomic weaknesses increase the risk of rehospitalization. 6 These problems cannot be addressed by medical interventions alone and require a multidisciplinary team-based approach. Japanese Health and Care SystemsSince 1961, Japan has had a healthcare system with universal health coverage, which provides substantial benefits and the same quality of medical care to citizens of all income levels. 7 Low-income people who are disabled because of illness, poverty, or unemployment can receive free medical care through public assistance. Indeed, Nishimoto et al recently reported that patients with acute HF who receive public assistance had no significant excess risk for all-cause death 1 year after discharge compared with those who did not receive public assistance. 8 In addition, to medical insurance, the Japanese government initiated mandatory public long-term care insurance (LTCI) in 2000 to help older individuals live more indepen-H eart failure (HF) is now a global pandemic that has become more common with increasingly aged populations. The mortality rate associated with HF is high despite new and increasingly effective drugs and non-pharmacological therapies. 1 According to the Japanese Registry of All Cardiac and Vascular Diseases (JROAD) conducted by The Japanese Circulation Society (JCS), the annual number of patients hospitalized for HF has increased and the annual number of patients hospitalized for HF was 3.5-fold higher than that of patients hospitalized for acute myocardial infarction. 2 Therefore, a Japanese strategic roadmap for HF management is urgently required.In 2016, the JCS and the Japan Stroke Society jointly created a 5-year plan for overcoming stroke and cardiovascular disease, aiming to extend healthy life expectancy. HF is listed as 1 of the 3 major therapeutic targets. 3 The JCS/ Japanese Heart Failure Society (JHFS) provided a new, public definition of HF in 2017. 4 The Cerebrovascular and Cardiovascular Disease Control Act of Japanese national law was enacted in December 2019, and the Ministry of Health, Labor, and Welfare, Japan, published the Japanese National Plan for Promotion of Measures Against Cerebrovascular and Cardiovascular Disease (Japanese

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“…In Japan, under the long-term care insurance system, care managers prepare a home care plan [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

The International Classification of Functioning, Disabilities, and Health Categories Necessary for Care Planning for Older Patients with Heart Failure: A Survey of Care Managers in Japan

Shiota

Kitagawa

Hidaka

et al. 2021

Preprint

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Background: Establishing an information-sharing system between medical professionals and welfare/care professionals may help prevent heart failure (HF) in community-dwelling older adults. Therefore, we aimed to identify the ICF categories necessary for care managers to develop care plans for older patients with HF. Methods: A questionnaire was administered to 695 care managers in Hiroshima, Japan, on ICF items necessary for care planning. We compared the care managers according to their specialties (medical and welfare). Furthermore, we created a co-occurrence network using text mining, regarding the elements necessary for collaboration between medical and care professionals. Results: There were 520 valid responses (74.8%). Forty-nine ICF items, including 18 for body functions, one for body structure, 21 for activities and participation, and nine for environmental factors, were classified as "necessary" for making care plans for older people with HF. Medical professionals more frequently answered "necessary" than care professionals regarding the 11 items for body functions and structure and three items for activities and participation (p<0.05). Medical–welfare/care collaboration requires (1) information sharing with related organisations; (2) emergency response; (3) a system of cooperation between medical care and non-medical care; (4) consultation and support for individuals and families with life concerns, (5) management of nutrition, exercise, blood pressure and other factors, (6) guidelines for consultation and hospitalisation when physical conditions worsen.Conclusions: Our findings showed that 49 ICF categories were required by care managers for care planning, and there was a significant difference in perception between medical and welfare/care professionals.

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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

Cited by 13 publications

References 13 publications

Patients with acute decompensated heart failure in an area with a super-aging society; A single- center, retrospective cohort study

Patients with acute decompensated heart failure in an area with a super-aging society; A single- center, retrospective cohort study

Developing Multidisciplinary Management of Heart Failure in the Super-Aging Society of Japan

The International Classification of Functioning, Disabilities, and Health Categories Necessary for Care Planning for Older Patients with Heart Failure: A Survey of Care Managers in Japan

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