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Aim: This study examined whether there is an association between continuous care rehabilitation (CR) and the risk of fracture hospitalization among people with Parkinson's disease (PwP) aged >75 years with mild‐to‐moderate care needs level. Methods: A retrospective study design based on the merging of medical claims and long‐term care insurance claims data was used. Before propensity score matching, of the 2177 participants, 222 received continuous CR, whereas 1955 did not. After matching using a 1:4 ratio, we identified 222 patients in the CR group and 888 patients in the non‐CR groups. We carried out a survival analysis to clarify the association between CR and the risk of fracture hospitalization. Results: After matching, there was a significant difference between the CR and non‐CR groups in 3 years (stratified log‐rank test by age P = 0.036) and in 4 years (stratified log‐rank test by age P = 0.011). The CR group was significantly associated with delays of hospital admission due to fracture within 3 years (hazard ratio 0.54; 95% confidence interval 0.29–0.99; P = 0.047) and within 4 years (hazard ratio 0.52; 95% confidence interval 0.30–0.88; P = 0.010). Conclusions: Our study showed that older people with Parkinson's disease who continuously received CR had a lower risk of fracture hospitalization in 3 and 4 years than those who did not receive CR or received interrupted CR. Considering our participants with a mild‐to‐moderate care needs level, a sustainable CR service might benefit people with Parkinson's disease from an early time when their activities of daily living are still intact and cognitive function has not deteriorated. Geriatr Gerontol Int 2022; 22: 628–634. [ABSTRACT FROM AUTHOR]

Objective: We aimed to ascertain the degree of influence of income disparity among older people with newly developed dementia on the probability and duration of stay in a hospital or long-term care facility and the degree of influence on medical expenses for hospitalization and care costs.Methods: This was a retrospective cohort study. Study participants included 12 829 individuals aged 75 years or older not diagnosed with dementia between April 2012 and March 2013 but newly diagnosed with dementia between April 2013 and March 2014. Participants were categorized according to income. We evaluated the associations of income with the probability and duration of stay in a hospital or long-term care facility and the costs for hospitalization and care.Results: In the adjusted analyses, high-income individuals had a lower probability of admission to a hospital or long-term care facility than middle- and high-income individuals. In all hospitals, low-income individuals had the longest duration of stay, but in long-term care facilities, income categories varied by facility type. Medical expenses for hospitalization and care costs were highest in the low-income group.Conclusion: Income category affects the probability and duration of stay in the hospital or a long-term care facility, as well as expenses for hospitalization and care. It is necessary to consider a policy to enable low-income older patients with dementia to continue living at home. [ABSTRACT FROM AUTHOR]

Aims/Introduction The objective of the present study was to evaluate the risk of diabetic macrovascular complications and in-hospital mortality among diabetic patients with irregular physician visits. Materials and Methods We carried out a health insurance-based retrospective cohort study using claims data from diabetic patients who were newly hospitalized between April 2010 and September 2010 among beneficiaries of the Fukuoka National Health Insurance Organization. Regular visits were defined as physician visits for diabetes mellitus at least every 3 months between April 2009 and March 2010, whereas other visits or no visits were defined as irregular visits. We assigned 5,940 patients to the regular visit or the irregular visit groups using propensity score matching. We compared in-hospital mortality and hospitalization for diabetic macrovascular complications between the two groups by multiple logistic regression models. Results The irregular visit group had a significantly higher risk of hospitalization for acute myocardial infarction ( AMI), ischemic heart diseases ( IHDs) except AMI, all IHDs, all strokes and diabetic macrovascular complications than did the regular visit group. Adjusted odds ratios for AMI, IHDs except AMI, all IHDs, all strokes, and diabetic macrovascular complications were 3.52 (95% confidence interval [ CI] 1.79-6.96), 1.25 (95% CI 1.02-1.54), 1.37 (95% CI 1.12-1.66), 1.29 (95% CI 1.04-1.60), and 1.28 (95% CI 1.10-1.48), respectively. Conclusions The present study shows that the irregular visit group had significantly higher risks of hospitalization for IHD and stroke among diabetic patients. Insurers need to motivate diabetic beneficiaries to make regular visits to physicians. [ABSTRACT FROM AUTHOR]