The pulmonary rehabilitation utilization rate among older people with chronic obstructive pulmonary disease in Japan: A retrospective study using medical and long-term care insurance claims data

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  • Kitamura Satomi
    Department of Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo
  • Igarashi Ayumi
    Department of Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo
  • Yoshie Satoru
    Institute of Gerontology, The University of Tokyo Institute for Future Initiatives (IFI), The University of Tokyo Department of Health Policy and Management, School of Medicine, Keio University Health Services Research & Development Center, University of Tsukuba
  • Morita Kojiro
    Health Services Research & Development Center, University of Tsukuba Department of Health Services Research, Faculty of Medicine, University of Tsukuba Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo
  • Jo Taisuke
    Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo Department of Health Services Research, Graduate School of Medicine, The University of Tokyo
  • Iijima Katsuya
    Institute of Gerontology, The University of Tokyo Institute for Future Initiatives (IFI), The University of Tokyo
  • Yamamoto-Mitani Noriko
    Department of Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo

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Other Title
  • 高齢慢性閉塞性肺疾患患者の呼吸リハビリテーションの利用実態：医療介護レセプトデータ分析
  • コウレイ マンセイ ヘイソクセイ ハイ シッカン カンジャ ノ コキュウ リハビリテーション ノ リヨウ ジッタイ : イリョウカイゴレセプトデータ ブンセキ

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Abstract

<p>Aim: This study aimed to improve the understanding of the utilization rates and the characteristics of users of pulmonary rehabilitation (PR) among people with chronic obstructive pulmonary disease.</p><p>Methods: We used medical and long-term care claims data from between April 2012 and March 2013 from Kashiwa city in Chiba prefecture, Japan. The study participants included patients of ≥63 years of age, who had received outpatient treatment for COPD (ICD-10 codes: J41-J44) two or more times during the study period, and who had been prescribed two or more COPD-related drugs. We extracted data on inpatient and outpatient PR using respiratory rehabilitation fee (I) (II) codes, and on home-based PR using home-care rehabilitation or nursing codes from medical insurance or long-term care insurance data.</p><p>Results: The mean age of the patients was 76.8 years (total participation: n = 2,708). There were 61 (2.3%) inpatient PR users, 25 (0.9%) outpatient PR users, and 101 (3.8%) home-based PR users. The median duration of usage by the inpatient, outpatient and home-based PR users was 1 month, 2 months, and 11 months, respectively. The mean age of non-PR and outpatient PR users was 76 years, while that of the inpatient PR users and home-based PR users was approximately 80 years. Approximately 20-30% of non-PR users and outpatient PR users were certified for long-term care. In contrast, approximately half of the inpatient users and almost all of the home-based PR users were certified for long-term care.</p><p>Conclusions: Since the PR utilization rates were low in both hospital-based and home-based settings, it is necessary to take measures to disseminate each PR based on the characteristics of the intervention duration and service users.</p>

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