Death in non-hospital/clinic settings of people certified as being eligible for long-term care insurance:A 10-year population-based cohort study

Abstract

Long-term outcomes of people certified as being eligible for long-term care insurance have not yet been well examined.　We conducted a population-based cohort study to examine the outcomes and death rate in non-hospital settings of elderly receiving care under long-term care insurance.　Participants were 2,338 elders aged 65 years or older who were certified as being eligible for the insurance between April 2003 and December 2004.　We combined the baseline data with the vital statistics.　Excluding 76 elders, who had moved to other areas, we followed up all the elders from the baseline.　Time until death was short in cases of cancer, cognitive impairment, multi-morbidity, others, no disease, musculoskeletal disorders, and cerebral vascular disease.　The mortality rate in elders with cognitive impairment or multi-morbidity was similar to that in those with cancer approximately eight years after the subjects had been assessed as requiring assistance and care, especially among females.　The rates of death in non-hospital settings were higher for “natural death” and lower for death from pneumonia than for death for cerebral vascular disease.　The rate of death in non-hospital settings was higher among males than among females.　Our results indicate priority targets to promote death in non-hospital/clinic settings.