Effects of gastrostomy fee schedule revision on artificial nutrition routes among older people with dementia in Japan: A time series observational study

Toshiki Maeda, Akira Babazono, Takumi Nishi, Hisatomi Arima, Masayoshi Tsuji, Miki Kawazoe, Atsushi Satoh

Research output: Contribution to journalArticle

Abstract

Aim: The present study aimed to investigate the effects of the 2014 Japanese fee schedule revision on trends in artificial nutrition routes, including gastrostomy, nasogastric tube and parenteral nutrition, among older people with dementia, using time series analysis. Methods: The study used claim data in Japan submitted to Fukuoka Late Elders' Health Insurance from fiscal year 2010 to fiscal year 2016. We identified older people with dementia provided for the first time with artificial nutrition via gastrostomy, nasogastric tube or central venous line and aggregated their data by month. Interrupted time series analyses were used to examine trends in artificial nutrition routes over time. Results: The numbers of older people with dementia receiving nutrition via gastrostomy, nasogastric tube and parenterally declined consistently. The slopes for pre-revision trends in gastrostomy, nasogastric tube and parenteral nutrition procedures were all significantly negative in the interrupted time series analyses. The post-revision trends in gastrostomy and parenteral nutrition continuously had significant negative slopes. In contrast, the significant negative trend in nasogastric tube procedures in the pre-revision period had disappeared during the post-revision period. Conclusions: The study showed that the fee schedule revision had limited impact on gastrostomy and parenteral nutrition. However the trend for nasogastric tube was ambiguous; hence, sustainable surveillance is required for evidence-based health policy. Geriatr Gerontol Int 2018; 18: 1405–1409.

Original languageEnglish
Pages (from-to)1405-1409
Number of pages5
JournalGeriatrics and Gerontology International
Volume18
Issue number9
DOIs
Publication statusPublished - Sep 1 2018

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Fee Schedules
Gastrostomy
dementia
fee
nutrition
Observational Studies
time series
Dementia
Japan
Parenteral Nutrition
trend
Health Insurance
Health Policy
time series analysis
health insurance
health policy
surveillance

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Gerontology
  • Geriatrics and Gerontology

Cite this

Effects of gastrostomy fee schedule revision on artificial nutrition routes among older people with dementia in Japan : A time series observational study. / Maeda, Toshiki; Babazono, Akira; Nishi, Takumi; Arima, Hisatomi; Tsuji, Masayoshi; Kawazoe, Miki; Satoh, Atsushi.

In: Geriatrics and Gerontology International, Vol. 18, No. 9, 01.09.2018, p. 1405-1409.

Research output: Contribution to journalArticle

Maeda, Toshiki ; Babazono, Akira ; Nishi, Takumi ; Arima, Hisatomi ; Tsuji, Masayoshi ; Kawazoe, Miki ; Satoh, Atsushi. / Effects of gastrostomy fee schedule revision on artificial nutrition routes among older people with dementia in Japan : A time series observational study. In: Geriatrics and Gerontology International. 2018 ; Vol. 18, No. 9. pp. 1405-1409.
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