| アブストラクト | As Japan becomes a super-aging society, presentation of the best ways to provide medical care for the elderly, and the direction of that care, are important national issues. Elderly people have multi-morbidity with numerous medical conditions and use many medical resources for complex treatment patterns. This increases the likelihood of inappropriate medical practices and an evidence-practice gap. The present study aimed to: derive findings that are applicable to policy from an elucidation of the actual state of medical care for the elderly; establish a foundation for the utilization of National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), and present measures for the utilization of existing databases in parallel with NDB validation.Cross-sectional and retrospective cohort studies were conducted using the NDB built by the Ministry of Health, Labor and Welfare of Japan, private health insurance claims databases, and the Kyoto University Hospital database (including related hospitals). Medical practices (drug prescription, interventional procedures, testing) related to four issues-potential inappropriate medication, cancer therapy, chronic kidney disease treatment, and end-of-life care-will be described. The relationships between these issues and clinical outcomes (death, initiation of dialysis and other adverse events) will be evaluated, if possible. |
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| 投稿者 | Nakayama, Takeo; Imanaka, Yuichi; Okuno, Yasushi; Kato, Genta; Kuroda, Tomohiro; Goto, Rei; Tanaka, Shiro; Tamura, Hiroshi; Fukuhara, Shunichi; Fukuma, Shingo; Muto, Manabu; Yanagita, Motoko; Yamamoto, Yosuke |
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| 組織名 | Department of Health Informatics, Kyoto University, School of Public Health,;Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.;nakayama.takeo.4a@kyoto-u.ac.jp.;Department of Healthcare Economics and Quality Management, Kyoto University;Graduate School of Medicine, School of Public Health, Kyoto, Japan.;Department of Biomedical Data Intelligence, Graduate School of Medicine, Kyoto;University, Kyoto, Japan.;Solutions Center for Health Insurance Claims, Kyoto University Hospital, Kyoto,;Japan.;Division of Medical Information Technology and Administration Planning, Kyoto;University Hospital, Kyoto, Japan.;Graduate School of Business Administration, Keio University, Yokohama, Japan.;Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto,;Faculty of Economics, Kyoto University, Kyoto, Japan.;Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto;Department of Healthcare Epidemiology, School of Public Health in the Graduate;School of Medicine, Kyoto University, Kyoto, Japan.;Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto |
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