Evidence map›Paper›PMID 38805415›Full record

ArticlePloS one2024

Trajectories of medical care expenditure in the last year of life associated with long-term care utilization in frail older adults: A retrospective cohort study.

Noriko Yoshiyuki, Takuma Ishihara, Ayumi Kono, Naomi Fukushima, Takeshi Miura, Katsunori Kaneko

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Noriko YoshiyukiDepartment of Community-based Integrated Care science, School of Nursing, Osaka Metropolitan University, Osaka, Japan.
Takuma IshiharaInnovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu University, Gifu, Japan.
Ayumi KonoLong-term Care Insurance Division, Department of Health and Welfare, Izumi City Municipal, Osaka, Japan.ORCID 0000-0002-8277-7141
Naomi FukushimaDepartment of Community-based Integrated Care science, School of Nursing, Osaka Metropolitan University, Osaka, Japan.
Takeshi MiuraDepartment of Community-based Integrated Care science, School of Nursing, Osaka Metropolitan University, Osaka, Japan.
Katsunori KanekoSchool of Economics, Osaka Metropolitan University, Osaka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMedical care and long-term care utilization in the last year of life of frail older adults could be a key indicator of their quality of life. This study aimed to identify the medical care expenditure (MCE) trajectories in the last year of life of frail older adults by investigating the association between MCE and long-term care utilization in each trajectory.

methodsThe retrospective cohort study of three municipalities in Japan included 405 decedents (median age at death, 85 years; 189 women [46.7%]) from a cohort of 1,658 frail older adults aged ≥65 years who were newly certified as support level in the long-term care insurance program from April 2012 to March 2013. This study used long-term care and medical insurance claim data from April 2012 to March 2017. The primary outcome was MCE over the 12 months preceding death. Group-based trajectory modeling was conducted to identify the MCE trajectories. A mixed-effect model was employed to examine the association between long-term care utilization and MCE in each trajectory.

resultsParticipants were stratified into four groups based on MCE trajectories over the 12 months preceding death as follows: rising (n = 159, 39.3%), persistently high (n = 143, 35.3%), minimal (n = 56, 13.8%), and descending (n = 47, 11.6%) groups. Home-based long-term care utilization was associated with increased MCE in the descending trajectory (coefficient, 1.48; 95% confidence interval [CI], 1.35-1.62). Facility-based long-term care utilization was associated with reduced MCE in the rising trajectory (coefficient, 0.59; 95% CI, 0.50-0.69). Both home-based (coefficient, 0.92; 95% CI, 0.85-0.99) and facility-based (coefficient; 0.53; 95% CI, 0.41-0.63) long-term care utilization were associated with reduced MCE in the persistently high trajectory.

conclusionsThese findings may facilitate the integration of medical and long-term care models at the end of life in frail older adults.

Indexed as

Frail ElderlyHealth ExpendituresLong-Term CareAgedAged, 80 and overFemaleHumansJapanMaleQuality of LifeRetrospective StudiesTerminal Care

Identifiers

PMID38805415
PMCPMC11132452

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.