Causes of applying Long-Term Care Insurance certification for patients with heart failure with systolic dysfunction

The number of patients with heart failure with disability and the use of Long-Term Care Insurance (LTCI) has been increasing in the Japanese aging society. This study investigated the main causes of LTCI demands for better care management.

We carried out a retrospective study including patients with heart failure with reduced ejection fraction in seven hospitals in Niigata City from 2011 to 2016. Data related to LTCI introduction, such as the main cause and degree of impairments, were collected from official documents for LTCI registration based on the doctor's opinion. Of 3738 patients, 312 were newly eligible for LTCI.

LTCI was introduced due to cardiac and non-cardiac diseases in 49.4% and 50.6% of patients, respectively. Physical impairment was milder in the cardiac group than major non-cardiac groups (Kruskal-Wallis test; P < 0.001, Steel test; cardiac vs cancer: P = 0.027 vs stroke: P < 0.001 vs orthopedic: P = 0.002 vs others: P = 0.041). Only the cancer group had a poorer prognosis than the cardiac group (log-rank test with Bonferroni correction; cardiac vs cancer: P < 0.001 vs stroke: P = 0.282 vs orthopedic disease: P = 0.866 vs others: P = 0.476).

Half of the LTCI users were introduced due to non-cardiac diseases in heart failure patients. The cause of LTCI indicating the degree of the patient's disability and prognosis is valuable information to provide favorable care. Geriatr Gerontol Int 2025; 25: 871-878.