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

Area of Science:

• Geriatric Medicine
• Cardiology
• Public Health

Background:

• The aging Japanese society faces a rising number of heart failure patients requiring long-term care.
• Long-Term Care Insurance (LTCI) use is increasing among disabled elderly individuals, necessitating an understanding of demand drivers.

Purpose of the Study:

• To investigate the primary causes of Long-Term Care Insurance (LTCI) demand in patients with heart failure with reduced ejection fraction.
• To inform better care management strategies by identifying the conditions leading to LTCI eligibility.

Main Methods:

• A retrospective study was conducted in seven hospitals in Niigata City, Japan, from 2011 to 2016.
• Data from 3738 patients with heart failure with reduced ejection fraction were analyzed, focusing on 312 newly eligible for LTCI.
• Information on the cause and degree of impairment for LTCI introduction was collected from official registration documents.

Main Results:

• Nearly half (49.4%) of LTCI demands were due to cardiac diseases, while 50.6% stemmed from non-cardiac conditions.
• Physical impairment was less severe in the cardiac group compared to major non-cardiac groups (e.g., cancer, stroke, orthopedic conditions).
• The cancer group exhibited a poorer prognosis than the cardiac group, unlike stroke, orthopedic, or other non-cardiac conditions.

Conclusions:

• Non-cardiac diseases are a significant factor in LTCI eligibility for heart failure patients, accounting for approximately half of all cases.
• Identifying the specific causes of disability and LTCI need is crucial for tailoring effective care management.
• This study highlights the importance of considering multifactorial causes of disability in heart failure patients for optimizing geriatric care.