Disease profile and model predicting prolong prognosis according to health and long-term care claims data on older adults certified as Support Level

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K21595
• Research Category: Grant-in-Aid for Challenging Research (Exploratory)
• Allocation Type: Multi-year Fund
• Review Section: Studies on the Super-Aging Society
• Research Institution: Osaka Metropolitan University (2022); Osaka City University (2019-2021)
• Principal Investigator: Kono Ayumi 大阪公立大学, 大学院看護学研究科, 教授 (00313255)
• Co-Investigator(Kenkyū-buntansha): 石原 拓磨 岐阜大学, 医学部附属病院, 助教 (00783193)
• Project Period (FY): 2019-06-28 – 2023-03-31
• Keywords: 虚弱高齢者 / 要支援高齢者 / 予後 / 死亡 / 疾患管理 / 併存疾患 / 慢性疾患

Outline of Final Research Achievements

The present cohort study aimed to profile chronic diseases and develop a model predicting prognosis leading to death by analyzing a dataset of long-term care (LTC) and health care claims, and LTC insurance certification information from 1,658 older adults certified as Support Level by LTC insurance. Analysis revealed that the number of cases of heart disease, lung disease, and hypertension frequently increased within one year of new LTC insurance certification. In particular, the number of cases of heart disease consistently increased one year before death. Analysis of a dataset from 405 decedents in the final year of life revealed that stroke occurrence was frequently observed in the rising trajectory of health care expenditures and cancer occurrence was observed frequently in the persistently high trajectory of health care expenditures. The use of health care and LTC resources tended to mutually complement one another in the final year of life of older adults.

Free Research Field

地域看護学，高齢者看護学

Academic Significance and Societal Importance of the Research Achievements

介護保険制度において要支援と新規に認定された時点から死亡に至るまでの疾患プロファイルを明らかにするための分析を行った．その結果，高齢者の新規認定から死亡に至るまで心疾患等をはじめとした慢性疾患に対するマネジメントのありかたを検討する必要性が示唆された．