ArticleAge and ageing2021
The impact of additional payments on functional decline among long-term care health facility residents in Japan.
Article in Age and ageing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Path analysis of the factors associated with oral health literacy among community-dwelling elderly individuals: a cross-sectional study.BMC oral health · 2026Article
- Staffing, nursing home, and market characteristics associated with caregiver turnover in Japan: a national cross-sectional study.BMC health services research · 2026Article
- The Effect of Business Operating Systems on Nursing Home Termination.International journal of public health · 2023Article
- Regional variation in long-term care spending in Japan.BMC public health · 2022Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdditional payment approach has been one of the most important incentives in long-term care (LTC) systems for the past 20 years in Japan.
objectiveTo estimate the effect of additional payments on functional decline in long-term care health facility (LTCHF) residents of Japan.
designA 24-month retrospective cohort study. SETTING AND SUBJECTS: Residents aged ≥65 years who were newly admitted to LTCHFs in the 2014 fiscal year.
methodsNational LTC claims data were linked to the survey of institutions and establishments for LTC. Competing risk regression was performed with functional decline as the primary outcome, and additional payments as exposure, controlling for individual and facility characteristics. The level of LTC needs certified in the LTC insurance system was applied as a proxy of functional ability. Death, hospitalisation, discharge to home and transfer to other LTC facilities were treated as competing events. Individual- and facility-level additional payments were presented as binary variables: being reimbursed or not during the follow-up period.
resultsAt baseline, 146,311 residents from 3,724 LTCHFs were included. The vast majority of additional payments were associated with a lower risk of functional decline at follow-up. At the individual level, additional payment for pre/post admission instructions had the strongest association with a lower risk of functional decline. Despite this, only 8% of residents were reimbursed for this additional payment. At the facility level, residents in LTCHFs with additional payments for support for home-life resumption and nutritional management were associated with a decreased risk of functional decline.
conclusionsThe results of our study may be of particular interest to policymakers in monitoring and evaluating additional payment approaches and provide insight into improving quality of care.
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