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Complex Multimorbidity and Incidence of Long-Term Care Needs in Japan: A Prospective Cohort Study

Author

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  • Daisuke Kato

    (Department of Family Medicine, Mie University Graduate School of Medicine, Tsu 514-8507, Japan)

  • Ichiro Kawachi

    (Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA 02115, USA)

  • Junko Saito

    (Center for Public Health Science, National Cancer Center Japan, Tokyo 104-0045, Japan)

  • Naoki Kondo

    (Science Frontier Laboratory, Department of Social Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Floor 2, Yoshida-konoe-cho, Sakyo-ku, Kyotoshi, Kyoto 606-8315, Japan)

Abstract

Complex multimorbidity (CMM) has been proposed as a more nuanced concept of multimorbidity (MM). We sought to quantify the association of CMM and MM on the incidence of long-term care (LTC) needs in a cohort of older Japanese people. Our follow-up was based on a nationwide longitudinal cohort study of people aged over 65 years who were functionally dependent at baseline. Our outcome was incident LTC needs, based on certification under the Japanese LTC insurance scheme. We used both propensity score matching and inverse probability of treatment weights (IPTW) to compare individuals with and without MM versus CMM. A total of 38,889 older adults were included: 20,233 (52.0%) and 7565 (19.5%) adults with MM and CMM, respectively. In propensity-matched analyses, both MM ( n = 15,666 pairs) and CMM ( n = 7524 pairs) were statistically significantly associated with the six-year LTC insurance certification rate (MM, hazard ratio (HR) 1.07, 95% confidence interval (95%CI) 1.02–1.12; CMM, HR 1.10, 95%CI 1.04–1.16). Both MM and CMM were associated with a modest but statistically significantly higher rate of LTC insurance certification. These findings support the inclusion of multimorbidity in the assessment of LTC insurance needs, although the Japanese government currently has not adopted this.

Suggested Citation

  • Daisuke Kato & Ichiro Kawachi & Junko Saito & Naoki Kondo, 2021. "Complex Multimorbidity and Incidence of Long-Term Care Needs in Japan: A Prospective Cohort Study," IJERPH, MDPI, vol. 18(19), pages 1-11, October.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:19:p:10523-:d:651282
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    1. Honaker, James & King, Gary & Blackwell, Matthew, 2011. "Amelia II: A Program for Missing Data," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 45(i07).
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    1. Daisuke Kato & Ichiro Kawachi & Naoki Kondo, 2022. "Complex Multimorbidity and Working beyond Retirement Age in Japan: A Prospective Propensity-Matched Analysis," IJERPH, MDPI, vol. 19(11), pages 1-10, May.

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