The use of Japanese long-term care insurance claims in health services research: current status and perspectives

Abstract

This study aims to evaluate the current status and perspectives on the use of Japanese long-term care (LTC) claims databases for research. We conducted a comprehensive literature search of PubMed and the Japan Medical Abstracts Society (Ichushi-Web), focusing on LTC claims data analyses published between 2000 and 2020. We summarized the study characteristics, database characteristics, and the research areas related to health services that were studied. In total, 86 journal articles (12 in Japanese and 74 in English) were included in our review. A particularly remarkable increase in the number of publications from 2016 to 2020 was observed. We extracted more publications with combined databases (n = 64) than those that only used a single source of the LTC claims databases (n = 22). More than half of the studies analyzed healthcare expenditure, healthcare utilization, and quality of care which were relevant to health services research. The most frequently mentioned limitation was the lack of validation in variables stored in the LTC claims databases. In conclusion, the LTC claims databases could serve as important sources of information for the evaluation of healthcare delivery, quality of care, and LTC policy.

Associations between long-term care-service use and service- or care-need level progression: a nationwide cohort study using the Japanese Long-Term Care Insurance Claims database

“…Another possible explanation is that there may have been an incentive for service users to under-report their health status in the certification survey, as recipients can receive more service when they are certified for higher support/care-need levels. Although declines in the support- or care-need level have been examined in several studies [ 3 – 6 , 10 , 17 , 18 ], this measure may be inappropriate for assessing the progression of disability.…”

“…The outcome of this study was progression in a support- or care-need level, as has been examined in similar studies [ 3 – 6 , 10 , 17 , 18 ]. In the present study, we defined progression as an increase of ≥ 1 in a support- or care-need level.…”

“…6-month period, and the long-term effects have remained uncertain [ 8 ]. Japan's Ministry of Health, Labour and Welfare (MHLW) started collecting anonymized data on the long-term care insurance system in 2010 from nearly all insurers and then developed a nationwide database called the Japanese Long-Term Care Insurance Claims database [ 9 , 10 ].…”

Facility staffing associated with potentially avoidable hospitalizations in nursing home residents in Japan: A retrospective cohort study.

“…The medical insurance claims data include medical diagnosis and type of medical visit (i.e., hospitalization or outpatient care) (18). The LTC insurance claims data include information regarding LTC residents, such as sex, age, care need level (CNL), location before facility admission, types of services provided, and dates of admission to or discharge from a nursing home (19). If the residents die in the nursing home, their date of death is also recorded.…”

Patterns of long‐term care service use and multimorbidity in older Japanese adults: A cross‐sectional study of claim data

“…Another limitation of previous studies was the lack of clinical diagnoses and medical information. 5,6,9,13 Some studies have examined LTC service utilization patterns in terms of diseases and focused on specific diseases or the coexistence of a small number of diseases, such as diabetes, cancer, and asthma. 14,15 However, as many older people have several comorbidities, it is necessary to consider certain diseases and concurrent conditions comprehensively.…”