TY - JOUR
T1 - Cumulative number of hospital bed days among older adults in the last year of life
T2 - A retrospective cohort study
AU - Ishizaki, Tatsuro
AU - Shimmei, Masaya
AU - Fukuda, Haruhisa
AU - Oh, Eun Hwan
AU - Shimada, Chiho
AU - Wakui, Tomoko
AU - Mori, Hiroko
AU - Takahashi, Ryutaro
N1 - Funding Information:
The authors would like to express their sincere appreciation to the municipal officers in Soma City. This work was supported by Japan Society for Promotion for Science Grants-in-Aid for Scientific Research (Grant Number 24590834) and the Ministry of Health, Labour and Welfare (H27-seisaku-senryaku-012). TI was responsible for study concept and design. TI, MS and RT contributed to acquisition of participants and data. TI, MS, HF, EHO, CS, TM, HM and RT carried out analysis and interpretation of data. TI and MS were responsible for preparation of the manuscript.
PY - 2017/5
Y1 - 2017/5
N2 - Aim: To determine whether age, proximity to death and long-term care insurance certification are related to receiving hospital inpatient care; the number of hospital bed days (HBD) among older Japanese adults in the last year of life; and to estimate the total number of HBD. Methods: Using health insurance claims and death certificate data, the present retrospective cohort study examined the HBD of city residents aged ≥65 years who died between September 2006 and October 2009 in Soma City, Japan. Using a two-part model, factors associated with receiving hospital inpatient care and the total number of HBD in each quarter in the last year of life were examined. Results: The total number of HBD in the last year of life varied widely; 13% had no admission, and 27% stayed ≥90 days. Younger age, approaching death and having long-term care insurance certification were significantly associated with being more likely to receive hospital inpatient care during each quarterly period in the last year of life. In contrast, having long-term care insurance certification and the last 3-month period before death, compared with the first 3-month period, were significantly associated with a fewer number of HBD. Conclusions: The present study showed that older age was associated with being less likely to receive hospital inpatient care. The findings regarding the risk of inpatient care and total number of HBD in the last year of life help to understand resource use among older dying adults, and to develop evidence-based healthcare policies within aging societies. Geriatr Gerontol Int 2017; 17: 737–743.
AB - Aim: To determine whether age, proximity to death and long-term care insurance certification are related to receiving hospital inpatient care; the number of hospital bed days (HBD) among older Japanese adults in the last year of life; and to estimate the total number of HBD. Methods: Using health insurance claims and death certificate data, the present retrospective cohort study examined the HBD of city residents aged ≥65 years who died between September 2006 and October 2009 in Soma City, Japan. Using a two-part model, factors associated with receiving hospital inpatient care and the total number of HBD in each quarter in the last year of life were examined. Results: The total number of HBD in the last year of life varied widely; 13% had no admission, and 27% stayed ≥90 days. Younger age, approaching death and having long-term care insurance certification were significantly associated with being more likely to receive hospital inpatient care during each quarterly period in the last year of life. In contrast, having long-term care insurance certification and the last 3-month period before death, compared with the first 3-month period, were significantly associated with a fewer number of HBD. Conclusions: The present study showed that older age was associated with being less likely to receive hospital inpatient care. The findings regarding the risk of inpatient care and total number of HBD in the last year of life help to understand resource use among older dying adults, and to develop evidence-based healthcare policies within aging societies. Geriatr Gerontol Int 2017; 17: 737–743.
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U2 - 10.1111/ggi.12777
DO - 10.1111/ggi.12777
M3 - Article
C2 - 27215376
AN - SCOPUS:84971280901
SN - 1447-0594
VL - 17
SP - 737
EP - 743
JO - Geriatrics and Gerontology International
JF - Geriatrics and Gerontology International
IS - 5
ER -