National trends in the proportion of in-hospital deaths by cause of death among older adults with long-term care: a nationwide observational study in Japan from 2007 to 2017

Taniguchi, Yuta; Iwagami, Masao; Jin, Xueying; Sakata, Nobuchika; Watanabe, Taeko; Hanari, Kyoko; Abe, Kazuhiro; Noguchi, Haruko; Tamiya, Nanako

doi:10.1186/s12877-021-02700-1

Cited by 5 publications

(2 citation statements)

References 18 publications

(20 reference statements)

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“…In fact, in 2005, we observed a decreasing trend in hospital deaths and an inverse increase in home deaths in Japan [ 4 ]. However, previous efforts have revealed that the decreasing trend of hospital deaths differs greatly depending on the cause of death (CoD) [ 5 , 6 ], and the details of this trend need to be examined individually.…”

Section: Introductionmentioning

confidence: 99%

Changes in the place of death before and during the COVID-19 pandemic in Japan

Shibata,

Otsuka,

Hagiya

et al. 2024

PLoS ONE

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Background In the global aging, the coronavirus disease 2019 (COVID-19) pandemic may have affected the place of death (PoD) in Japan, where hospital deaths have dominated for decades. We analyzed the PoD trends before and during the COVID-19 pandemic in Japan. Methods This nationwide observational study used vital statistics based on death certificates from Japan between 1951 and 2021. The proportion of PoD; deaths at home, hospitals, and nursing homes; and annual percentage change (APC) were estimated using joinpoint regression analysis. Analyses were stratified by age groups and causes of death. Results After 2019, home deaths exhibited upward trends, while hospital death turned into downward trends. By age, no significant trend change was seen in the 0–19 age group, while hospital deaths decreased in the 20–64 age group in 2019. The trend change in home death in the ≥65 age group significantly increased since 2019 with an APC of 12.3% (95% confidence interval [CI]: 9.0 to 15.7), while their hospital death trends decreased by −4.0% (95% CI: −4.9 to −3.1) in 2019−2021. By cause of death, home death due to cancer and the old age increased since 2019 with an APC of 29.3% (95% CI: 25.4 to 33.2) and 8.8% (95% CI: 5.5 to 12.2), respectively. Conclusion PoD has shifted from hospital to home during the COVID-19 pandemic in Japan. The majority of whom were older population with cancer or old age.

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Section: Introductionmentioning

confidence: 99%

Changes in the place of death before and during the COVID-19 pandemic in Japan

Shibata,

Otsuka,

Hagiya

et al. 2024

PLoS ONE

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“…However, Japan has a low proportion of in-home or facility deaths compared to Western countries such as Canada, the UK, and the US (Taniguchi et al [13]; National Vital Statistics System, 2020). From a policy perspective, it is essential to understand how to bridge the gap between people's wishes and reality at the end of their lives in LTC settings.…”

Section: Introductionmentioning

confidence: 99%

Provision of Palliative Care for Patients with Advanced Dementia across Various Long-Term Care Settings in Japan: A Questionnaire-Based Survey

Hirakawa,

Komatsu,

Saito

et al. 2024

Preprint

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Long-term care (LTC) settings are increasingly used for palliative care in Japan. This study aimed to assess the proportion of LTC settings that provide palliative care services for older clients with advanced dementia in Japan and the trends across the types of settings. A nationwide questionnaire survey was conducted between November 2022 and January 2023, targeting 1,000 geriatric hospitals (GHs), 1,000 geriatric health services facilities (GHSFs), and 1,000 home nursing care stations (HNCSs). The palliative care practices for older patients with advanced dementia and their families in the agencies were assessed. Less than half of the GHs supported family participation or the spiritual needs of their older clients with dementia, while many had access to pain and symptom assessments and analgesic prescriptions by physicians. Less than half the GHSFs used pain assessment tools, assessed and supported family caregivers' pain and distress, and supported family participation in palliative care. More than 80% of the HNCSs practiced most of the listed palliative care. Current palliative care practices for older adults with dementia vary among GHs, GHSFs, and HNCSs. This emphasizes the need for targeted approaches to improve the provision of palliative care for patients with dementia across LTC settings in Japan.

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Effect of China’s long-term care insurance on health outcomes of older disabled people: role of institutional care

Zhou

Zhu²,

Yan³

et al. 2023

International Journal for Quality in Health Care

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Background Since the public long-term care insurance (LTCI) system was piloted in Chengdu, China in October 2017, there has been a considerable growth of LTC institutions in China. This study aimed to evaluate the health value effect of LTCI in older patients with severe disabilities in an LTC institution. Methods This prospective study was based on data from 985 severe disability patients with or without LTCI from October 2017 to May 2021 in the Eighth People’s Hospital, Chengdu, China. The Cox proportional hazard model estimated LTCI’s health value, including survival probability and risk of pneumonia/pressure ulcers. Subgroup analysis was performed for sex, age, Charlson Comorbidity Index (CCI), and the number of drugs. Results In the analysis 519 and 466 patients in LTCI and non-LTCI groups, respectively, were included. In adjusted Cox analyses, the LTCI group had a significantly elevated survival rate compared with the non-LTCI groups at 12 months (P<0.001, HR=1.758, 95% CI 1.300-2.376). At 40 months, the adjusted survival rate was 62.6% in the LTCI group, which was significantly higher (53.7%; P=0.003, HR=1.438, 95% CI 1.131-1.831). The subgroups of patients aged 60 to 79 years (interaction P=0.007) and CCI≥3 (interaction P=0.026) were more significantly associated with survival improvement than those aged >80 years and CCI< 3. The LTCI group was also at lower risk for hospital-acquired pneumonia (P=0.016, HR 0.622, 95% CI 0.422-0.917) and pressure ulcers (P=0.008, HR 0.695, 95% CI 0.376-0.862). The improved survival of LTCI remained stable in sensitivity analyses. Conclusion For older patients with severe disabilities, in a long-term care institution, LTCI significantly improved their health profile and longevity after a year, suggesting the large role and development potentiality of institution care in the LTCI system of China.

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National trends in the proportion of in-hospital deaths by cause of death among older adults with long-term care: a nationwide observational study in Japan from 2007 to 2017

Cited by 5 publications

References 18 publications

Changes in the place of death before and during the COVID-19 pandemic in Japan

Changes in the place of death before and during the COVID-19 pandemic in Japan

Provision of Palliative Care for Patients with Advanced Dementia across Various Long-Term Care Settings in Japan: A Questionnaire-Based Survey

Effect of China’s long-term care insurance on health outcomes of older disabled people: role of institutional care

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