Annals of Clinical Epidemiology
Online ISSN : 2434-4338
最新号
選択された号の論文の4件中1~4を表示しています
SEMINAR
  • Takaaki Konishi, Haruhi Inokuchi, Hideo Yasunaga
    原稿種別: SEMINAR
    2024 年 6 巻 1 号 p. 1-4
    発行日: 2024年
    公開日: 2024/01/04
    [早期公開] 公開日: 2023/06/10
    ジャーナル オープンアクセス HTML

    In Japan, a public long-term care insurance system was launched in 2000. Residents can receive long-term care according to their care needs, as determined by a nationally standardized certification system. The present report describes the details of the long-term care services covered by public insurance. The Long-Term Care Insurance Act categorizes services into three major types: in-home, nursing-home, and community-based long-term care services. In-home care services include visiting, commuting, short-stay, and other services. Welfare, health, and medical facilities provide nursing-home care services for the elderly. Community-based care services were categorized into visiting, commuting, nursing-home, and composite services.

STUDY PROTOCOL
  • Takanori Honda, Hiroko Furuhashi, Yoshihiko Furuta, Shoko Tomooka, Tak ...
    原稿種別: STUDY PROTOCOL
    2024 年 6 巻 1 号 p. 5-11
    発行日: 2024年
    公開日: 2024/01/04
    [早期公開] 公開日: 2023/10/21
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    BACKGROUND

    The Fukuoka-City Information Platform for Community-based Integrated Care is an advanced big data platform that aggregates information on the health and medical services of Fukuoka citizens. Fukuoka City is engaged in a joint project with Kyushu University to promote policy making through a large-scale real-world data analysis. This paper describes the framework for this cooperative effort and the features of the analytical platform.

    METHODS

    Fukuoka City is the fifth most populous ordinance-designated city in Japan, with an estimated population of approximately 1.6 million. Under an agreement with Fukuoka City, Kyushu University was granted access to a portion of the city’s anonymized healthcare database as secondary-use information. The database contains information on resident registration, health insurance claims, specific health checkups and health checkups for the older adults, specific health guidance, long-term care insurance data, and cancer screenings collected after fiscal year 2012. Each of these constituent datasets can be interlinked using anonymized hashed key variables, allowing individuals to be followed across databases and over time.

    CONCLUSIONS

    The platform allows longitudinal investigation of the complex association between various aspects of healthcare, such as medical procedures, examinations, interviews, medical costs, long-term care certifications, and care costs. The platform can provide valuable public-health information because it is relatively large for a single database, and because it allows analysis of data across multiple domains and tracing of individuals over time.

SHORT REPORT
ORIGINAL ARTICLE
  • Wakana Maki, Nobuaki Michihata, Yohei Hashimoto, Hiroki Matsui, Kiyohi ...
    原稿種別: ORIGINAL ARTICLE
    2024 年 6 巻 1 号 p. 17-23
    発行日: 2024年
    公開日: 2024/01/04
    [早期公開] 公開日: 2023/11/10
    ジャーナル オープンアクセス HTML
    電子付録

    BACKGROUND

    Nasal continuous positive airway pressure (NCPAP), nasal intermittent positive pressure ventilation (NIPPV), and high-flow nasal cannula (HFNC) are often used after initial extubation in preterm infants. However, data regarding the choice between NCPAP/NIPPV and HFNC are limited. This study examined which therapy was more effective as post-extubation support.

    METHODS

    This is a retrospective, cohort study that used the Diagnosis Procedure Combination database in Japan, 2011–2021. Propensity score overlap weighting analyses were performed to compare the composite outcomes of in-hospital death and reintubation in preterm infants who received NCPAP/NIPPV and HFNC. We identified infants born at gestational age 22–36 weeks who were intubated within 1 day of birth. We included patients who underwent NCPAP/NIPPV or HFNC after initial extubation. Patients with airway obstruction or congenital airway abnormalities were excluded.

    RESULTS

    We identified 1,203 preterm infants treated with NCPAP/NIPPV (n = 525) or HFNC (n = 678). The median (interquartile range) gestational age at delivery was 30 (27–33) weeks, and birth weight was 1296 (884–1,802) g. Compared with the HFNC group, the NCPAP/NIPPV group had a significantly lower proportion of the composite outcome after the overlap weighting analysis (risk ratio, 0.62; 95% confidence interval, 0.47 to 0.83; p = 0.001). This significant difference was also observed in infants born at gestational age 22–31 weeks, whereas no significant difference was observed in infants born at gestational age 32–36 weeks.

    CONCLUSIONS

    NCPAP/NIPPV may be a superior post-extubation support than HFNC in preterm infants, especially in those born at gestational age of 22–31 weeks.

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