{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:26:16Z","timestamp":1787023576163,"version":"build-2736575974"},"reference-count":14,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Kounonaka Fund of the Osaka Community Foundation","award":["2026-No. 10"],"award-info":[{"award-number":["2026-No. 10"]}]},{"name":"National Cancer Center Research and Development Fund","award":["2023-A-24"],"award-info":[{"award-number":["2023-A-24"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Terminally ill patients with cancer may have difficulty using Japan\u2019s public long-term care insurance system because functional decline often occurs rapidly near death. We examined care-need levels, service use, and factors associated with timely service use in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used anonymized long-term care insurance claims data from January 2018 to August 2025. Patients who died of cancer and whose first observed certification was granted within 1\u00a0year before death were included. Certification levels, certification period, and service use were described. Logistic regression examined factors associated with service use within 30\u00a0days after first certification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 10\u2009491 patients, 17.8% were initially classified as support levels 1 and 2, and 62.0% were first certified within 3\u00a0months before death. Overall, 6740 (64.2%) used long-term care services during observation, and 4822 (46.0%) used services within 30\u00a0days. Compared with patients certified 6 to \u2264\u00a012\u00a0months before death, those certified closer to death had higher odds of service use within 30\u00a0days: adjusted odds ratios were 1.63 (95% CI, 1.43\u20131.84) for \u2264\u00a01\u00a0month, 1.23 (1.09\u20131.40) for 1 to \u2264\u00a03\u00a0months, and 1.17 (1.02\u20131.34) for 3 to \u22646\u00a0months. Higher initial care-need levels were also associated with greater service use within 30\u00a0days, peaking at care-need level 2 (5.73; 4.78\u20136.88).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Many patients were first certified shortly before death. Certification closer to death was associated with prompt service use, possibly reflecting urgent care coordination. Earlier information provision and timely certification may help patients access long-term care services before death.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jjco\/hyag130","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:15:08Z","timestamp":1785237308000},"source":"Crossref","is-referenced-by-count":0,"title":["Long-term care needs and service use in terminally ill patients with cancer: a nationwide claims data study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4265-1787","authenticated-orcid":false,"given":"Richi","family":"Takahashi","sequence":"first","affiliation":[{"name":"Division of Policy Evaluation, Institute for Cancer Control, National Cancer Center , 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 ,","place":["Japan"]},{"name":"Division of Quality Assurance Programs, Institute for Cancer Control, National Cancer Center , 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9538-4419","authenticated-orcid":false,"given":"Takaaki","family":"Konishi","sequence":"additional","affiliation":[{"name":"Division of Health Services Research, Institute for Cancer Control, National Cancer Center , 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3658-4514","authenticated-orcid":false,"given":"Yoko","family":"Nakazawa","sequence":"additional","affiliation":[{"name":"Division of Policy Evaluation, Institute for Cancer Control, National Cancer Center , 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 ,","place":["Japan"]},{"name":"Division of Quality Assurance Programs, Institute for Cancer Control, National Cancer Center , 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1913-6955","authenticated-orcid":false,"given":"Daisuke","family":"Fujisawa","sequence":"additional","affiliation":[{"name":"Division of Quality Assurance Programs, Institute for Cancer Control, National Cancer Center , 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"2026081722584780300_ref1","doi-asserted-by":"publisher","first-page":"2387","DOI":"10.1001\/jama.289.18.2387","article-title":"Patterns of functional decline at the end of life","volume":"289","author":"Lunney","year":"2003","journal-title":"JAMA"},{"key":"2026081722584780300_ref2","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1200\/JCO.2010.30.7173","article-title":"Trajectory of performance status and symptom scores for patients with cancer during the last six months of life","volume":"29","author":"Seow","year":"2011","journal-title":"J Clin Oncol"},{"key":"2026081722584780300_ref3","volume-title":"Overview of the Long-term Care Insurance System","author":"Ministry of Health, Labour and Welfare"},{"key":"2026081722584780300_ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.37737\/ace.24001","article-title":"Services in public long-term care insurance in Japan","volume":"6","author":"Konishi","year":"2024","journal-title":"Ann Clin Epidemiol"},{"key":"2026081722584780300_ref5","first-page":"41","article-title":"\u4ecb\u8b77\u4fdd\u967a\u5236\u5ea6\u306b\u304a\u3051\u308b\u304c\u3093\u672b\u671f\u306e\u4f4d\u7f6e\u3065\u3051\u306b\u95a2\u3059\u308b\u53f2\u7684\u7814\u7a76 [A historical study on the treatment of terminal cancer in the long-term care insurance]","volume":"59","author":"Takeda","year":"2014","journal-title":"Bull Mimasaka Univ Mimasaka Univ Jun Coll"},{"key":"2026081722584780300_ref6","volume-title":"34th Meeting, Material 2-1: Proposal to Add Terminal Cancer to the Specified Diseases","author":"Social Security Council, Long-Term Care Benefit Expenses Subcommittee","year":"2005"},{"key":"2026081722584780300_ref7","first-page":"18","article-title":"\u672b\u671f\u304c\u3093\u60a3\u8005\u306b\u5bfe\u3059\u308b\u4ecb\u8b77\u4fdd\u967a\u30b5\u30fc\u30d3\u30b9\u306e\u63d0\u4f9b\u306b\u95a2\u3059\u308b\u8abf\u67fb\u7d50\u679c\u306b\u3064\u3044\u3066 [Survey results regarding the provision of long-term care insurance services to patients with terminal cancer]","volume":"21","author":"Atsuko","year":"2013","journal-title":"Hospice Home Care"},{"key":"2026081722584780300_ref8","author":"Medical and Healthcare Database Utilization Committee, Japanese Society for Pharmacoepidemiology"},{"key":"2026081722584780300_ref9","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1111\/ggi.13777","article-title":"Correlation between the Barthel Index and care need levels in the Japanese long-term care insurance system","volume":"19","author":"Matsuda","year":"2019","journal-title":"Geriatr Gerontol Int"},{"key":"2026081722584780300_ref10","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data","volume":"43","author":"Quan","year":"2005","journal-title":"Med Care"},{"key":"2026081722584780300_ref11","volume-title":"Vital Statistics of Japan","author":"Ministry of Health, Labour and Welfare, Japan"},{"key":"2026081722584780300_ref12","author":"Ministry of Health, Labour and Welfare, Japan"},{"key":"2026081722584780300_ref13","first-page":"1","article-title":"Comparison of three methods for raising an elderly person from a traditional futon mattress","volume":"35","author":"Hidaka","year":"2006","journal-title":"J Hum Ergol (Tokyo)"},{"key":"2026081722584780300_ref14","article-title":"Home care duration and service use among elderly patients with terminal cancer in Japan: a nationwide study using the Japanese long-term care insurance claims","volume":"73","author":"Maura","year":"2026","journal-title":"Nihon Koshu Eisei Zasshi"}],"container-title":["Japanese Journal of Clinical 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