Background: We aimed to assess whether the United States-developed Claims-based Frailty Index (CFI) can be implemented in Japanese older adults using claims data.
Methods: We used the monthly claims data and certification of long-term care (LTC) insurance data of residents from 12 municipalities from April 2014 to March 2019. The 12 months from first recording was defined as the "baseline period," and the time thereafter as the "follow-up period". Participants aged ≥65 years were included, and those with no certified LTC insurance or who died at baseline were excluded. New certification of LTC insurance and all-cause mortality during the follow-up period were defined as outcome events. CFI categorization consisted of three steps including: 1) using 12 months deficit-accumulation approach that assigned different weights to each of the 52 items; 2) the accumulated score to derive the CFI; and 3) categorizing the CFI as "robust" (<0.15), "prefrail" (0.15-0.24), and "frail" (≥0.25). Kaplan-Meier survival curves and Cox proportional hazard models were used to determine the association between CFI and outcomes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated.
Results: There were 519,941 participants in total. After adjusting for covariates, the severe CFI category had a high risk of certification of LTC insurance (prefrail: HR 1.33; 95% CI, 1.27-1.39 and frail: HR 1.60; 95% CI, 1.53-1.68) and all-cause mortality (prefrail: HR 1.44; 95% CI, 1.29-1.60 and frail: HR 1.84; 95% CI, 1.66-2.05).
Conclusion: This study suggests that CFI can be implemented in Japanese claims data to predict the certification of LTC insurance and mortality.
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http://dx.doi.org/10.2188/jea.JE20220310 | DOI Listing |
Nurs Health Sci
December 2024
College of Nursing, Inha University, Incheon, South Korea.
This study examined the factors associated with medical expenses among LTCI (long-term care insurance) recipients in Korea. Secondary data analysis was performed using the 2019 Korea National Health Insurance (KNHI) reimbursement data of I metropolitan city. Data from 52 434 older adults who were LTCI recipients and living in I metropolitan city areas were included.
View Article and Find Full Text PDFHealth Policy
November 2024
Department of Health Policy and Management, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
This case study presents an evidence-building approach to support policy planning for integrated health and care delivery for older adults. We developed an integrated needs-assessment framework to monitor the complex long-term medical and care needs of older individuals, using routinely collected, standardized needs-assessment and utilization data from the public health and long-term care (LTC) insurance systems in South Korea. We also developed a set of misuse indicators and analyzed service utilization patterns, while accounting for their varying types of needs.
View Article and Find Full Text PDFBMC Geriatr
August 2024
Department of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan.
Background: Older adults requiring care often have multiple morbidities that lead to polypharmacy, including the use of potentially inappropriate medications (PIMs), leading to increased medical costs and adverse drug effects. We conducted a cross-sectional study to clarify the actual state of drug prescriptions and the background of polypharmacy and PIMs.
Methods: Using long-term care (LTC) and medical insurance claims data in the Ibaraki Prefecture from April 2018 to March 2019, we included individuals aged ≥ 65 who used LTC services.
J Am Geriatr Soc
November 2024
Center for Advancing Health Services, Policy & Economics Research, Institute of Public Health at Washington University, St. Louis, Missouri, USA.
Background: Although many healthcare settings have since returned to pre-pandemic levels of operation, long-term care (LTC) facilities have experienced extended and significant changes to operations, including unprecedented levels of short staffing and facility closures, that may have a detrimental effect on resident outcomes. This study assessed the pandemic's extended effect on outcomes for LTC residents, comparing outcomes 1 and 2 years after the start of the pandemic to pre-pandemic times, with special focus on residents with frailty and dually enrolled in Medicare and Medicaid.
Methods: Using Medicare claims data from January 1, 2018, through December 31, 2022, we ran over-dispersed Poisson models to compare the monthly adjusted rates of emergency department use, hospitalization, and mortality among LTC residents, comparing residents with and without frailty and dually enrolled and non-dually enrolled residents.
J Gerontol A Biol Sci Med Sci
September 2024
Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan.
Background: Long-term care (LTC) costs create burdens on aging societies. Maintaining oral health through dental visits may result in shorter LTC periods, thereby decreasing LTC costs; however, this remains unverified. We examined whether dental visits in the past 6 months were associated with cumulative LTC insurance (LTCI) costs.
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