Geriatrics & gerontology international · 2025
Impact of dementia and hip fracture onset on the healthcare and long-term care burden: Healthcare and long-term care insurance data analyses in Sendai City, Japan.
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Nakatoh Shinichi, Fujimori Kenji, Ishii Shigeyuki, Tamaki Junko, Okimoto Nobukazu, Ogawa Sumito, Iki Masayuki
Аннотация
AIM: This study aimed to examine the differences in the impact of dementia and hip fracture onset on the burden of healthcare and long-term care.
METHODS: This retrospective cohort study utilized electronic medical receipt data issued between April 2019 and March 2023 from the National Health Insurance scheme and the medical care system for older individuals aged ≥75 years from Sendai City. Female patients aged ≥65 years who were newly registered as patients with dementia (n = 2696) and/or hip fracture (n = 1118) were investigated. Monthly healthcare and long-term care costs for 12 months before and after the entry were analyzed.
RESULTS: After the onset of dementia, a very small temporary change was observed in healthcare and long-term care costs, which then tended to increase gradually throughout the entire course. By contrast, after the onset of hip fracture with and without dementia, healthcare costs temporarily increased for 3-4 months, while the long-term care costs temporarily decreased. Subsequently, long-term care costs rose and high costs followed compared with before the onset of hip fracture. In the hip fracture with dementia group, an upward trend in long-term care costs was observed within 12 months before entry but not after entry. Long-term care costs could not increase further because they might reach the maximum cost.
CONCLUSIONS: With the onset of hip fractures, the level of care for patients with dementia would further increase. Hence, fracture prevention measures for patients with dementia are important. Geriatr Gerontol Int 2025; 25: 677-685.
METHODS: This retrospective cohort study utilized electronic medical receipt data issued between April 2019 and March 2023 from the National Health Insurance scheme and the medical care system for older individuals aged ≥75 years from Sendai City. Female patients aged ≥65 years who were newly registered as patients with dementia (n = 2696) and/or hip fracture (n = 1118) were investigated. Monthly healthcare and long-term care costs for 12 months before and after the entry were analyzed.
RESULTS: After the onset of dementia, a very small temporary change was observed in healthcare and long-term care costs, which then tended to increase gradually throughout the entire course. By contrast, after the onset of hip fracture with and without dementia, healthcare costs temporarily increased for 3-4 months, while the long-term care costs temporarily decreased. Subsequently, long-term care costs rose and high costs followed compared with before the onset of hip fracture. In the hip fracture with dementia group, an upward trend in long-term care costs was observed within 12 months before entry but not after entry. Long-term care costs could not increase further because they might reach the maximum cost.
CONCLUSIONS: With the onset of hip fractures, the level of care for patients with dementia would further increase. Hence, fracture prevention measures for patients with dementia are important. Geriatr Gerontol Int 2025; 25: 677-685.