Characteristics of Older Patients at the Start of Medical and Long-Term Care at the Place of Discharge After Acute Care Who Needed Continuous Medical Care: Analysis of a Nationwide Administrative Database in Japan

Kunio Tarasawa,¹ Kenji Fujimori¹ and Kiyohide Fushimi²

¹Department of Health Administration and Policy, Graduate School of Medicine, Tohoku University, Sendai, Japan
²Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan

Japan has the largest aged population globally, and the number of older people requiring medical and long-term care is increasing yearly. Therefore, providing older people with appropriate medical and long-term care in their living setting is essential. This study will clarify the characteristics of older patients who started medical and long-term care in their place of living following acute inpatient treatment, focusing on the differences between their homes and nursing homes. The analysis was conducted using Japan’s nationwide administrative database. We collected discharge records of patients aged 65 and older who received acute inpatient treatment. Those who started medical and long-term care at home or admission a nursing home at the time of discharge were selected and categorized into the home group and the nursing home group. Patient characteristics were shown by group, and factors determining group differences were estimated using univariate and multivariate logistic regression analysis. We selected 89,705 people in the home group and 92,969 in the nursing home group. The home group had a significantly higher rate of cancer, while the nursing home group had a significantly higher age, long-term care need level, and dementia. It became clear that the home group was highly dependent on medical care, and the nursing home group was highly reliant on long-term care. Furthermore, the age group of those admissions to nursing homes varied by sex. These results are expected to provide basic information useful in practice for medical professionals, care workers, and policymakers.

Key words —— database; home medical care; long-term care; nursing home; older patients

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Tohoku J. Exp. Med., 2025 May, 266(2), 161-171.

Correspondence: Kunio Tarasawa, Department of Health Administration and Policy, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.

e-mail: tarasawa@med.tohoku.ac.jp