Association between recorded medical diagnoses and incidence of long-term care needs certification: a case control study using linked medical and long-term care data in two Japanese cities

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Author(s)

    • Iwagami Masao
    • Department of Health Services Research, Faculty of Medicine, University of Tsukuba|Health Services Research and Development Center, University of Tsukuba
    • Ueshima Hiroaki
    • Health Services Research and Development Center, University of Tsukuba
    • Yoshie Satoru
    • Health Services Research and Development Center, University of Tsukuba|Institute of Gerontology, The University of Tokyo|Department of Health Policy and Management, School of Medicine, Keio University
    • Ishizaki Tatsuro
    • Health Services Research and Development Center, University of Tsukuba|Human Care Research Team, Tokyo Metropolitan Institute of Gerontology
    • Ito Tomoko
    • Department of Health Services Research, Faculty of Medicine, University of Tsukuba|Health Services Research and Development Center, University of Tsukuba
    • Tamiya Nanako
    • Department of Health Services Research, Faculty of Medicine, University of Tsukuba|Health Services Research and Development Center, University of Tsukuba
    • Taniguchi Yuta
    • University of Tsukuba Hospital|Graduate School of Comprehensive Human Sciences, University of Tsukuba
    • Jin Xueying
    • Department of Health Services Research, Faculty of Medicine, University of Tsukuba|Health Services Research and Development Center, University of Tsukuba
    • Mori Takahiro
    • Department of Health Services Research, Faculty of Medicine, University of Tsukuba|Health Services Research and Development Center, University of Tsukuba|Department of General Internal Medicine, Eastern Chiba Medical Center
    • Hamada Shota
    • Health Services Research and Development Center, University of Tsukuba|Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare
    • Shinozaki Tomohiro
    • Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science
    • Suzuki Mamoru
    • Department of Health Services Research, Faculty of Medicine, University of Tsukuba|Health Services Research and Development Center, University of Tsukuba
    • Uda Kazuaki
    • Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo

Abstract

<p><b>BACKGROUND</b></p><p>It is unknown which medical diagnoses are strongly associated with long-term care needs certification.</p><p><b>METHODS</b></p><p>We conducted a case-control study using linked medical and long-term care data from two Japanese cities. The participants were aged ≥75 years, without any previous long-term care needs certification, and had at least one medical insurance claim record during a period between April 2013 and March 2015 in City A and between April 2013 and November 2016 in City B. Cases were newly certified people for long-term care needs during the study period, whereas controls (matched on age category, sex, city, and calendar date) were randomly selected in a 1:4 ratio. We conducted multivariable conditional logistic regression analyses to estimate the association between 22 categories of medical diagnoses recorded in the past six months and new (i.e., first ever) long-term care needs certification.</p><p><b>RESULTS</b></p><p>Among 38,338 eligible people, 5,434 (14.2%) newly received long-term care needs certification. The adjusted odds ratio (95% confidence interval) was largest for femur fractures, 8.80 (6.35–12.20), followed by dementia, 6.70 (5.96–7.53), pneumonia, 3.72 (3.19–4.32), hemorrhagic stroke, 3.31 (2.53–4.34), Parkinson's disease, 2.74 (2.07–3.63), and other fractures, 2.68 (2.38–3.02). A restricted analysis to more severe outcome (care need levels 2 to 5), sensitivity analysis to use different periods for exposure definition, and separate analysis by city showed consistent results.</p><p><b>CONCLUSIONS</b></p><p>Among a range of recorded medical diagnoses, fractures (especially femur fractures), dementia, pneumonia, hemorrhagic stroke, and Parkinson's disease were strongly associated with long-term care needs certification.</p>

Journal

  • Annals of Clinical Epidemiology

    Annals of Clinical Epidemiology 1(2), 56-68, 2019

    Society for Clinical Epidemiology

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