Complex Multimorbidity and Incidence of Long-Term Care Needs in Japan: A Prospective Cohort Study.
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.
['Kato|Daisuke|D|0000-0002-2449-0548', 'Kawachi|Ichiro|I|', 'Saito|Junko|J|', 'Kondo|Naoki|N|']
D000368:Aged D015331:Cohort Studies D006801:Humans D015994:Incidence D007353:Insurance, Long-Term Care D007564:Japan D008134:Long-Term Care D008137:Longitudinal Studies D000076322:Multimorbidity D011446:Prospective Studies
complex multimorbidity multimorbidity long-term care needs