Main medical conditions of frail elderly patients that require intensive care under the Japanese Long-Term Care Insurance (LTCI) system: a comparison with German LTCI.

Background: Although the number of frail elderly individuals has rapidly increased with global aging, few studies have assessed the main medical conditions that are covered by Long-Term Care Insurance (LTCI) systems.

Objectives and methods: To improve preventive care strategies, the author researched data from 553 frail elderly individuals above 65 years of age in the Osaka central area. Logistic regression analysis was used to identify severe diseases associated with levels of care higher than level 3 (3+) under the Japanese LTCI system, which is equivalent to the care standards of the German LTCI system. The main medical conditions were also compared between the LTCI systems of both countries.

Results: Diseases significantly associated with Japanese level of care 3+ were renal failure (odds ratio 6.3), fracture (5.3), dementia (4.4), and cerebrovascular disease (CVD; 2.5) in males and fracture (7.5), heart failure (3.6), dementia (3.3), CVD (2.9), and depression (2.8) in females. Main medical conditions in Japanese patients by gender were dementia (males 29%, females 21%), CVD (males 27%, females 22%), neoplasm (males 11%), and fracture or fracture sequelae (females 24%). Among German LTCI recipients, the main medical conditions by gender were diseases of the circulatory system (males 23%, females 19%) and mental and behavioral disorders (males 17%, females 20%).

Conclusion: Dementia and diseases of the circulatory system, especially CVD, were the most common main recipients. Intensive blood pressure control and thorough diabetes treatment are the top preventive healthcare strategies for both diseases of the circulatory system and dementia to avoid disease progression and accumulation. Early detection and treatment of cancer in males and prevention of fractures in females are of particular importance.