Cost of shifting from healthcare to long-term care in later life across major diseases: analysis of end-of-life care during the last 24 months of life

Tomoko Terada; Keiko Nakamura; Kaoruko Seino; Masashi Kizuki; Naohiko Inase

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Cost of shifting from healthcare to long-term care in later life across major diseases: analysis of end-of-life care during the last 24 months of life

VernacularTitle:Cost of shifting from healthcare to long-term care in later life across major diseases: analysis of end-of-life care during the last 24 months of life
Author: Tomoko TERADA ¹ ; Keiko NAKAMURA ² ; Kaoruko SEINO ² ; Masashi KIZUKI ³ ; Naohiko INASE ⁴
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1. Department of Integrated Pulmonology, Tokyo Medical and Dental University, Japan
2. Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Japan
3. Department of Environmental Health Sciences, School of Public Health, The University of Michigan, USA
4. Department of Health Promotion, Tokyo Medical and Dental University, Japan
Keywords: end-of-life; cost; healthcare; long-term care; Japan
From:Journal of Rural Medicine 2018;13(1):40-47
CountryJapan
Language:English
Abstract: Aim: To evaluate the costs associated with healthcare and long-term care during the last 24 months before death according to major disease groups.Methods: Individual data regarding healthcare and long-term care costs according to public insurance schemes during the last 24 months before death among all decedents older than 75 years reported in a city in Japan between April 1, 2010 and March 31, 2014 were identified; the data for nine major diseases were then analyzed.Results: For the 2149 decedents studied, the average healthcare costs per capita in the last 24 months of life for moderately-old (75 to 84 years) and extremely-old (85 years and older) decedents was 4,135,467 JPY and 2,493,001 JPY, respectively, while the average long-term care costs per capita for 24 months was 1,300,710 JPY and 2,723,239 JPY, respectively. The total costs (healthcare and long-term care combined) ranged from 9,169,547 JPY for chronic kidney disease to 5,023,762 JPY for ischemic heart disease. In all the diseases studied, the moderately-old decedents incurred higher healthcare costs while the extremely-old decedents incurred higher long-term care costs. However, for the care costs of chronic lower respiratory diseases, this pattern was not observed.Conclusion: A shift in expenditure from healthcare to long-term care as the decedents’ age increased was observed in major diseases, with some exceptions.