Analysis of centenarians' and non-centenarians' actual cases of health services coverage for one year before death using national health and long-term care insurance claims

利用国民健康和长期护理保险理赔对百岁老人和非百岁老人生前一年医疗服务承保的实际案例进行分析

• 批准号: 21K21208
• 负责人: 中西 康裕
• 金额: $ 2万
• 依托单位: National Institute of Public Health
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Research Activity Start-up
• 财政年份: 2021
• 资助国家: 日本
• 起止时间: 2021-08-30 至 2024-03-31
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-21K21208/
• 关键词: 医療・介護レセプト; 百寿者; スーパーセンチナリアン; 寿命; 医療・介護費; KDB; 要介護度; 介護サービス

本研究の目的は、大規模な医療・介護突合レセプトデータを用いることにより、百寿者（100歳以上）及び非百寿者（100歳未満）の死亡前1年間の保険診療・介護の利用実態を明らかにすることである。令和4年度は、2013年4月～2020年3月までの7年間の奈良県KDBを用いて、死亡者の匿名化されたIDごとに死亡日から遡った1年間の入院及び入院外医療費、介護費、疾患情報、要介護度等のデータを抽出・集計し、死亡前1年間の医療・介護費総額を分析した。また、後期高齢者医療制度加入者を対象として、医療費と介護費それぞれの年度ごとの総額を抽出し、「後期高齢者医療事業状況報告」や「介護保険事業状況報告」等の既存統計により妥当性を検証した。死亡前1年間の医療・介護費総額の分析結果は、次年度論文等により発表予定である。奈良県の75歳以上の後期高齢者を対象とした死亡前医療・介護費総額の分析では、百寿者の死亡前1年間に発生する医療費は非百寿者（75-99歳）と比較して低い傾向にある一方、死亡前1年間の介護費は年齢が上がるにつれて増加する傾向にあった。死亡前1年間に発生する医療・介護費総額は、死亡前30日（1ヵ月）間では年齢が上がるにつれて減少する傾向にあるものの、年齢が上がるほど介護費が増加する影響により、死亡日から遡るほど百寿者と非百寿者の1人当たり死亡前医療・介護費総額の差は小さくなった。また、在宅医療に関する診療行為コードや、通所介護、通所リハビリテーション、居宅療養管理指導、訪問看護等の介護サービスコードを整理し、各コードを掛け合わせた患者数・利用者数等の粗集計を行った。次年度では、さらに在宅医療や介護サービス別に死亡前1年間の保険診療・介護の利用状況明らかにし、長野県KDBにおいても奈良県と同様の傾向が見られるかを検証する予定である。

The purpose of this study is to monitor the use of health care in the first year before the death of those who are over 100 years old, those who are over 100 years old, and those who are not 100 years old. During the 7-year period from April 2013 to March 2020, Nara's KDB medical records were collected, and the deceased was anonymized. The ID patients were admitted to the hospital and the hospital was admitted to the hospital during the one-year period. The clinical data were collected, and the medical media was responsible for medical care analysis in the year before death. For those who participate in the medical care system for those with advanced health care in the later period, those who participate in the medical care system in the later period, those who participate in the medical care system in the later period, those who participate in the medical care system in the later period, those who participate in the medical care system in the later period, those who participate in the medical care system in the later period, those who participate in the medical care system in the later period, those who participate in the medical care system in the later period, those who participate in the medical care system in the later period, those who participate in the medical care system in the later period, those who participate in the medical care system in the later period, those who participate in the medical care system in the later period, those who participate in the medical care system in the later period, those who participate in the medical care system in the later period, and so on, the existing statistics are appropriate. In the one year before death, the medical staff monitored the results of the analysis of medical records, the results of the papers of the next year, and other clinical tables to determine the number of patients. In Nara, those with high levels of post-life sickness over 75 years old, such as those with high levels of health care before death, those who were not 100 years old in the year before death, those who were not 100 years old (75-99 years old), were lower than those who were not 100 years old, and those who received medical treatment during the year before death and those who were not 100 years old, and those who received medical treatment during the year before death. One year before death, one hundred years before death, one person who was not a hundred-year-old, one person who was not a hundred-year-old, one person who was not a hundred-year-old. Health care, in-house medical personnel, general health care, general health care, residential housing management guidance, residential health care, etc., and the rough set accounting for the number of users, such as the number of users, and so on. In the next year, the doctor and doctor will be in charge of health care and health care in the year prior to the death of each other. In the year before the death of the doctor, the health care agency will make use of the license to inform the doctor and the Nagano KDB doctor to send a license to the doctor in Nara.

项目成果

FORECASTING THE REGIONAL DISTRIBUTION OF HOME CARE PATIENTS USING BIG DATA OF INSURANCE CLAIMS IN JAPAN: 2015 TO 2045

• DOI: 10.1093/geroni/igac059.557
• 发表时间: 2022-12-20
• 期刊: Innovation in Aging
• 影响因子: 7

医療・介護保険レセプトを用いた要介護状態の契機となった入院主病名及び手術名の分析

利用医疗护理保险收据分析引发需要护理状况的主要疾病名称和手术名称

• 发表时间: 2021
• 作者: Yasuhiro Nakanishi;Yuichi Nishioka;Yukio Tsugihashi;Tomohiro Kakinuma;Tatsuya Noda;Tomoaki Imamura;Manabu Akahane;中西康裕，西岡祐一，次橋幸男，柿沼倫弘，野田龍也，今村知明，赤羽学;山口佳小里，中西康裕，西岡祐一，次橋幸男，野田龍也，北村哲郎，城戸顕，今村知明，赤羽学;中西康裕，次橋幸男，早坂章，西岡祐一，今村知明，赤羽学;次橋幸男，赤羽学，中西康裕，明神大也，久保慎一郎，西岡祐一，野田龍也，今村知明
• 通讯作者: 次橋幸男，赤羽学，中西康裕，明神大也，久保慎一郎，西岡祐一，野田龍也，今村知明

大規模レセプトデータを用いた後期高齢者を対象としたリハビリテーション医療の需要に関する圏域別将来推計

利用大规模收据数据对区域未来老年人康复医疗需求进行估算

• 发表时间: 2022
• 作者: 山口佳小里;中西康裕;西岡祐一;次橋幸男;野田龍也;北村哲郎;城戸顕;今村知明;赤羽学
• 通讯作者: 赤羽学

大規模レセプトデータを用いた在宅医療需要の将来推計手法の確立

建立利用大规模收据数据估算未来家庭医疗需求的方法

• 发表时间: 2022
• 作者: 中西康裕;西岡祐一;次橋幸男;柿沼倫弘;野田龍也;今村知明;赤羽学
• 通讯作者: 赤羽学

アドバンス・ケア・プランニングの実施経験に関するWEB質問紙調査

关于实施预先护理计划的经验的网络问卷调查

• 发表时间: 2022
• 作者: 中西康裕;次橋幸男;早坂章;西岡祐一;今村知明;赤羽学
• 通讯作者: 赤羽学