2021 Volume 6 Pages 31-40
【Objective】 In recent years, the number of elderly people hospitalized for pneumonia has been increasing. In particular, attention is focused on the increase in pneumonia in the elderly who are already in need of long term care insurance services, but few studies have analyzed the current situation in detail. The purpose of this study was to analyze the current state of pneumonia in the elderly using medical and long-term care claim data from a local government in western Japan, and to discuss countermeasures.
【Materials and method】 The data used for the analysis are the medical claim (National Health Insurance / Medical care system for the late elderly) and the long-term care insurance (LTCI) claim from April 2012 to March 2017 of one local government in western Japan. We created a database that concatenated these data on an individual basis, and extracted patients who were treated at DPC hospitals for elderly pneumonia (DPC 6 digits = 040080 and 040081), and were hospitalized for the first time. The year and month of the admission were defined as the starting year and month of observation. With this as the starting point (treatment month, elapsed month = 0), the status of medical care service usage and the status of injury and illness before and after that were analyzed.
【Results】 As a result of this analysis, 32.1% of elderly patients admitted to an acute care hospital for pneumonia received some kind of LTCI service for general pneumonia and 53.3% for aspiration pneumonia 6 months before admission. In addition, most of them returned directly to their homes (outpatient / home) after treatment. The cumulative mortality rate for one year after admission was 17.8% for general pneumonia and 31.3% for aspiration pneumonia.
【Discussion】 Given the high cumulative mortality rate for one year, the types of comorbidities, and their high prevalence, pneumonia is an important condition influencing quality of life for the elderly in need of care at the end of life stage. Therefore, in order to maintain QOL at that time, it is important to implement appropriate care management in order to prevent pneumonia.
