Hospitalization for Respiratory Tract Infections Increase the Use of Medical Care and Long-Term Care Services: A Pre-Post Assessment Adopting Difference-in-Differences Analysis on LIFE Study Data
Author(s)
Ryosuke Uemura, MHA, MD, Haruhisa Fukuda, MPH, PhD;
Kyushu University Graduate School of Medical Sciences, Department of Health Care Administration and Management, Fukuoka, Japan
Kyushu University Graduate School of Medical Sciences, Department of Health Care Administration and Management, Fukuoka, Japan
Presentation Documents
OBJECTIVES: To quantify the socioeconomic burden of respiratory tract infections (RTIs), we observed and described the changes in the use of medical care (MC) and long-term care (LTC) services before and after RTI-related hospitalization.
METHODS: This study utilized data provided by the Longevity Improvement & Fair Evidence (LIFE) Study, which is an ongoing database project that collects claims data for MC and LTC services from multiple Japanese municipalities. We identified RTI-related hospitalizations in residents aged ≥65 years between April 2019 and March 2022, and compared each individual’s use of MC and LTC services between one year before and one year after this event. Next, we estimated the socioeconomic burden of RTIs using conditional logistic regression analysis with a difference-in-differences approach. Each case was matched with four controls for age, sex, and observation duration in the same municipality.
RESULTS: Among 2,627,757 participants from 12 municipalities, 21,800 hospitalized cases of bacterial or fungal pneumonia were observed between April 2019 and March 2022. The attributable risks of MC and LTC services due to RTI-related hospitalization were as follows: outpatient MC, -0.079 (95% confidence interval: -0.084, -0.075); in-home MC, 0.038 (0.031-0.044); inpatient MC, 0.101 (0.092-0.110); ambulatory LTC/day care, -0.024 (-0.033, -0.016); in-home LTC, 0.023 (0.016-0.031); and facility-based LTC, 0.055 (0.047-0.063). The estimated odds ratios that adjusted for underlying time-dependent trends were as follows: outpatient MC, 0.25 (95% confidence interval: 0.22-0.27); in-home MC, 1.05 (0.98-1.12); inpatient MC, 1.38 (1.32-1.45); ambulatory LTC/day care, 0.83 (0.79-0.88); in-home LTC, 1.04 (0.98-1.11); and facility-based LTC, 1.26 (1.18-1.34).
CONCLUSIONS: This large-scale pre-post assessment using real-world Japanese healthcare data found that RTI-related hospitalization significantly increased the use of inpatient MC and facility-based LTC services, but reduced the use of outpatient MC and ambulatory LTC services. These findings suggest that RTIs’ socioeconomic burden could be reduced through appropriate preventive measures.
METHODS: This study utilized data provided by the Longevity Improvement & Fair Evidence (LIFE) Study, which is an ongoing database project that collects claims data for MC and LTC services from multiple Japanese municipalities. We identified RTI-related hospitalizations in residents aged ≥65 years between April 2019 and March 2022, and compared each individual’s use of MC and LTC services between one year before and one year after this event. Next, we estimated the socioeconomic burden of RTIs using conditional logistic regression analysis with a difference-in-differences approach. Each case was matched with four controls for age, sex, and observation duration in the same municipality.
RESULTS: Among 2,627,757 participants from 12 municipalities, 21,800 hospitalized cases of bacterial or fungal pneumonia were observed between April 2019 and March 2022. The attributable risks of MC and LTC services due to RTI-related hospitalization were as follows: outpatient MC, -0.079 (95% confidence interval: -0.084, -0.075); in-home MC, 0.038 (0.031-0.044); inpatient MC, 0.101 (0.092-0.110); ambulatory LTC/day care, -0.024 (-0.033, -0.016); in-home LTC, 0.023 (0.016-0.031); and facility-based LTC, 0.055 (0.047-0.063). The estimated odds ratios that adjusted for underlying time-dependent trends were as follows: outpatient MC, 0.25 (95% confidence interval: 0.22-0.27); in-home MC, 1.05 (0.98-1.12); inpatient MC, 1.38 (1.32-1.45); ambulatory LTC/day care, 0.83 (0.79-0.88); in-home LTC, 1.04 (0.98-1.11); and facility-based LTC, 1.26 (1.18-1.34).
CONCLUSIONS: This large-scale pre-post assessment using real-world Japanese healthcare data found that RTI-related hospitalization significantly increased the use of inpatient MC and facility-based LTC services, but reduced the use of outpatient MC and ambulatory LTC services. These findings suggest that RTIs’ socioeconomic burden could be reduced through appropriate preventive measures.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD28
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Infectious Disease (non-vaccine), SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)