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

  • Iwagami Masao
    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
  • Adomi Motohiko
    University of Tsukuba Hospital
  • 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
  • Ueshima Hiroaki
    Health Services Research and Development Center, University of Tsukuba
  • Iijima Katsuya
    Institute of Gerontology, The University of Tokyo
  • 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

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Abstract

<p>BACKGROUND</p><p>It is unknown which medical diagnoses are strongly associated with long-term care needs certification.</p><p>METHODS</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>RESULTS</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>CONCLUSIONS</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>

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