2021 Volume 6 Pages 49-57
【Objective】 In recent years, the number of elderly people hospitalized due to heart failure has increased. This heart failure pandemic is expected to become a more serious problem as the population ages. Many of these patients are already elderly with multiple chronic illnesses and are presumed to follow the course of the terminal with repeated acute exacerbations of heart failure, but the situation has not always been clarified by objective data. The purpose of this study was to analyze the current state of cardiac failure in the elderly using medical and long-term care claims from a local government in western Japan, and to examine 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 heart failure (DPC first 6 digits = 050130), 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, 32.0% of elderly patients admitted to an acute care hospital for cardiac failure received some kind of long-term care service 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 17.9%.
【Discussion】 Given the high cumulative mortality rate for one year, the types of comorbidities and their prevalence, and the high prevalence of heart failure even after discharge, heart failure is an important medical condition that influences the quality of life in end stage for the elderly requiring LTCI services. Therefore, in order to maintain QOL at that time, it is important to firmly position measures to prevent the worsening of heart failure, specifically management of risk factors such as hypertension, diabetes mellitus and inappropriate dietary habits, etc. in care management process.
