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Association of long‐term care needs, approaching death and age with medical and long‐term care expenditures in the last year of life: An analysis of insurance claims data
Author(s) -
Mori Hiroko,
Ishizaki Tatsuro,
Takahashi Ryutaro
Publication year - 2020
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.13865
Subject(s) - medicine , long term care , ambulatory care , inpatient care , service (business) , gerontology , long term care insurance , medical care , health care , family medicine , medical emergency , nursing , economy , economics , economic growth
Aim This study aimed to examine whether long‐term care needs, approaching death and age were associated with the use of medical and long‐term care resources (care/service use and expenditures) in the last year of life among older Japanese individuals. Methods Using data on insurance claims and death certificates, we described the use of medical and long‐term care resources in the last year of life by residents of Soma City in Japan aged ≥65 years who died between September 2006 and October 2009. Using a generalized estimating equation, we examined whether long‐term care needs, approaching death and age were associated with resource use during each 3‐month period in the last year of life. Results Resource use in medical and long‐term care among 882 non‐survivors and 8504 survivors were analyzed. Analyses for the non‐survivors showed statistically significant associations between: (i) severe long‐term care needs and greater service use in outpatient care, higher expenditures for outpatient care and higher expenditures for in‐home/facility services; (ii) approaching death and greater use in both inpatient care and facility services; and (iii) being aged 65–74 years and greater service use in outpatient/in‐hospital care and in‐home/facility services, higher expenditures in outpatient/inpatient care, and lower expenditures for in‐home/facility services. Conclusions The present study showed that severe long‐term care needs and approaching death, rather than advancing age, were significantly and independently associated with greater use of resources in both medical and long‐term care services. Geriatr Gerontol Int 2020; 20: 277–284 .