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.
Age Factors
Aged
Aged, 80 and over
Cohort Studies
Female
Frail Elderly
Heart Failure
/ epidemiology
Home Care Services
/ statistics & numerical data
Hospitalization
/ statistics & numerical data
Humans
Insurance, Long-Term Care
/ statistics & numerical data
Japan
/ epidemiology
Long-Term Care
Male
Outcome Assessment, Health Care
Proportional Hazards Models
Prospective Studies
Registries
acute heart failure
home- and community-based services
long-term care insurance
prognosis
Journal
Geriatrics & gerontology international
ISSN: 1447-0594
Titre abrégé: Geriatr Gerontol Int
Pays: Japan
ID NLM: 101135738
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
15
04
2020
revised:
13
07
2020
accepted:
25
07
2020
pubmed:
21
8
2020
medline:
21
10
2020
entrez:
21
8
2020
Statut:
ppublish
Résumé
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). 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). The study participants were eligible for LTCI two times more than community-dwelling 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). 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. Geriatr Gerontol Int 2020; 20: 967-973.
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
967-973Subventions
Organisme : Osaka University
Informations de copyright
© 2020 Japan Geriatrics Society.
Références
Cabinet Office, Government of Japan. The present and future situation of aging. [Cited 8 Apr 2020.] Available from URL: https://www8.cao.go.jp/kourei/whitepaper/w-2019/zenbun/pdf/1s1s_01.pdf.
Cabinet Office, Government of Japan. The international trend of aging. Available from URL: https://www8.cao.go.jp/kourei/whitepaper/w-2019/zenbun/pdf/1s1s_02.pdf.
Tamiya N, Noguchi H, Nishi A et al. Population ageing and wellbeing: lessons from Japan's long-term care insurance policy. Lancet 2011; 378: 1183-1192.
Tsuchihashi M, Tsutsui H, Kodama K, Kasagi F, Takeshita A. Clinical characteristics and prognosis of hospitalized patients with congestive heart failure-a study in Fukuoka, Japan. Jpn Circ J 2000; 64: 953-959.
Cabinet Office, Government of Japan. Annual Report on the Ageing Society: 2018. [Cited 8 Apr 2020.] Available from URL: https://www8.cao.go.jp/kourei/whitepaper/w-2010/zenbun/html/s1-2-3-02.html.
Cabinet Office, Government of Japan. Annual Report on the Ageing Society: 2018. [Cited 8 Apr 2020.] Available from URL: https://www8.cao.go.jp/kourei/whitepaper/w-2018/html/zenbun/s1_2_2.html
Tomita N, Yoshimura K, Ikegami N. Impact of home and community-based services on hospitalisation and institutionalisation among individuals eligible for long-term care insurance in Japan. BMC Health Serv Res 2010; 10: 345.
Stuck AE, Egger M, Hammer A, Minder CE, Beck JC. Home visits to prevent nursing home admission and functional decline in elderly people: systematic review and meta-regression analysis. JAMA 2002; 287: 1022-1028.
Liebel DV, Friedman B, Watson NM, Powers BA. Review of nurse home visiting interventions for community-dwelling older persons with existing disability. Med Care Res Rev 2009; 66: 119-146.
Takabayashi K, Ikuta A, Okazaki Y et al. Clinical characteristics and social frailty of super-elderly patients with heart failure-the Kitakawachi clinical background and outcome of heart failure registry. Circ J 2016; 81: 69-76.
Ho KK, Pinsky JL, Kannel WB, Levy D. The epidemiology of heart failure: the Framingham study. J Am Coll Cardiol 1993; 22: 6A-13A.
Tsutsui H, JCS 2017/JHFS 2017. Guidelines for diagnosis and treatment of acute and chronic heart failure. [Cited 8 Apr 2020.] Available from URL: http://www.j-circ.or.jp/guideline/pdf/JCS2017_tsutsui_h.pdf.
Tokyo Metropolitan Government. Structure of the long-term care insurance system. [Cited 8 Apr 2020.] Available from URL: http://www.fukushihoken.metro.tokyo.jp/kourei/koho/kaigo_pamph.files/p.1kaigohoken-english.pdf.
Ministry of Health, Labour and Welfare. Long-term care insurance system of Japan. 2016. [Cited 8 Apr 2020.] Available from URL: https://www.mhlw.go.jp/english/policy/care-welfare/care-welfare-elderly/dl/ltcisj_e.pdf.
Ministry of Health, Labour and Welfare. About home-visit nursing. [Cited 8 Apr 2020.] Available from URL: https://www.mhlw.go.jp/stf/shingi/2r9852000001uo3f-att/2r9852000001uo71.pdf.
Lichstein E, Sharma A. Changing endpoints for heart failure studies. J Am Coll Cardiol 2018; 71: 2653-2655.
Hirakata City. Estimated amount of care insurance service and care insurance premiums. [Cited 8 Apr 2020.] Available from URL: https://www.city.hirakata.osaka.jp/kourei/cmsfiles/contents/0000002/2153/70006.pdf.
Ministry of Health, Labour and Welfare. Long-term care insurance business status report. [Cited 8 Apr 2020.] Available from URL: https://www.mhlw.go.jp/topics/kaigo/osirase/jigyo/15/dl/h27_zenkokukei.pdf.
Fujii N, Naito K, Nakahara N, Nakano A, Takagi S. Clinical characteristics and outcomes in super-elderly patients with heart failure. Acute Med Surg 2014; 2: 76-82.
Takabayashi K, Kitaguchi S, Iwatsu K et al. A decline in activities of daily living due to acute heart failure is an independent risk factor of hospitalization for heart failure and mortality. Circ J 2018; 73: 522-529.
Takahashi K, Saito M, Inaba S et al. 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. Open Heart 2016; 3: e000501.
Bouman A, van Rossum E, Evers S, Ambergen T, Kempen G, Knipschild P. Effects on health care use and associated cost of a home visiting program for older people with poor health status: a randomized clinical trial in The Netherlands. J Gerontol A Bio Sci Med Sci 2008; 63: 291-297.
Osaka City. Long-term care insurance service user and non-user survey. [Cited 8 Apr 2020.] Available from URL: https://www.city.osaka.lg.jp/fukushi/cmsfiles/contents/0000303/303624/riyoumiriyoukaigosya.pdf (accessed April 8, 2020).