{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:02:00Z","timestamp":1790233320037,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100016342","name":"Ministry of Health Mexico","doi-asserted-by":"publisher","award":["23AA2003"],"award-info":[{"award-number":["23AA2003"]}],"id":[{"id":"10.13039\/100016342","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016342","name":"Ministry of Health Mexico","doi-asserted-by":"publisher","award":["24AA2006"],"award-info":[{"award-number":["24AA2006"]}],"id":[{"id":"10.13039\/100016342","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>In 2016, Japan introduced a dementia care add\u2010on (DCA; levels 1 and 2) to incentivize hospital\u2010based dementia care. However, nationwide characteristics of eligible patients, including care processes and outcomes, remain unclear. We conducted a descriptive national analysis of DCA\u2010eligible inpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed a national inpatient database in Japan, including patients aged \u2265\u200965\u2009years admitted between fiscal years 2016 and 2019 who met DCA eligibility criteria\u2014moderate\u2010to\u2010severe dementia without severe consciousness disturbance. Patient characteristics, DCA uptake, care utilization indicators, and outcomes were summarized by year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1\u2009046\u2009652 hospitalizations, patients were predominantly of advanced age (mean 85.4\u2009years) and functionally dependent, with &gt;\u200970% requiring full assistance with activities of daily living at admission and discharge. Patient characteristics remained stable over time; approximately 20% were admitted for pneumonia or aspiration pneumonia. From 2016 to 2019, DCA1 and DCA2 billings increased from 6.4% to 20.8% and from 13.2% to 32.8%, respectively. Mean length of stay declined from 33.7 to 27.8\u2009days, and in\u2010hospital mortality from 13.9% to 12.9%. Potentially inappropriate medication use at discharge decreased from 16.2% to 14.0%. In\u2010hospital fractures remained stable at 0.9%\u20131.0%. About half of patients admitted from home were discharged home.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DCA\u2010eligible inpatients are highly vulnerable. Despite increased uptake, coverage remained incomplete. This study provides baseline data to inform dementia care policy and future evaluations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.70824","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T03:18:42Z","timestamp":1788923922000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nationwide Descriptive Analysis of Older Inpatients Eligible for Japan's Dementia\u2010Care Financial Incentive in Acute\u2010Care Hospitals"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9165-244X","authenticated-orcid":false,"given":"Jinyan","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Gerontological Home Care and Long\u2010Term Care Nursing, Graduate School of Medicine The University of Tokyoss  Tokyo Japan"},{"name":"Public Interest Incorporated Foundation Health Care Science Institute  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2306-0669","authenticated-orcid":false,"given":"Kojiro","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Nursing Administration and Advanced Clinical Nursing, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5292-8893","authenticated-orcid":false,"given":"Ayumi","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Department of Advanced Gerontological Nursing, Graduate School of Nursing, School of Nursing Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6017-469X","authenticated-orcid":false,"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3857-5267","authenticated-orcid":false,"given":"Taro","family":"Kojima","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine International University of Health and Welfare  Narita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4400-8576","authenticated-orcid":false,"given":"Taisuke","family":"Yasaka","sequence":"additional","affiliation":[{"name":"Department of Nursing Data Science, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1649-0596","authenticated-orcid":false,"given":"Yuya","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1894-0290","authenticated-orcid":false,"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences Institute of Science Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1704-7011","authenticated-orcid":false,"given":"Noriko","family":"Yamamoto\u2010Mitani","sequence":"additional","affiliation":[{"name":"Department of Gerontological Home Care and Long\u2010Term Care Nursing, Graduate School of Medicine The University of Tokyoss  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"World Alzheimer Report 2015 the Global Impact of Dementia: An Analysis of Prevalence, Incidence, Cost and Trends","author":"Prince M.","year":"2015"},{"key":"e_1_2_11_3_1","volume-title":"Dementia Statistics","author":"Alzheimer's Disease International","year":"2022"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4919"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/opn.12315"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.08.004"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4993"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.108.055335"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15282"},{"key":"e_1_2_11_10_1","volume-title":"Annual Report on the 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Central Social Insurance Medical Council \u201cEvaluation of Care for Dementia Patients With Physical Diseases General Meeting (the 328th) \u201d(2016) https:\/\/www.mhlw.go.jp\/file\/05\u2010Shingikai\u201012404000\u2010Hokenkyoku\u2010Iryouka\/0000112306.pdf[in Japanese]."},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S104161021700240X"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.5537"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2019.103470"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.37737\/ace.24015"},{"key":"e_1_2_11_16_1","first-page":"1","article-title":"Functional Evaluation: The Barthel Index: A Simple Index of Independence Useful in Scoring Improvement in the Rehabilitation of the Chronically Ill","volume":"14","author":"Mahoney F. 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Central Social Insurance Medical Council \u201cStatus of Notification of Major Facility Standards General Meeting (the 591st) \u201d(2023) https:\/\/www.mhlw.go.jp\/content\/12404000\/001270650.pdf[in Japanese]."},{"key":"e_1_2_11_30_1","volume-title":"Survey of Medical Care in Inpatient and Outpatient Settings: Facility Survey Form (A)","author":"Ministry of Health, Labour and Welfare","year":"2022"},{"key":"e_1_2_11_31_1","volume-title":"Survey of Medical Care in Inpatient Settings, FY2019 (Facility Questionnaire)","author":"Ministry of Health, Labour and Welfare, Japan","year":"2020"},{"key":"e_1_2_11_32_1","volume-title":"Overview of the 2020 Revision of Medical Service Fees","author":"Ministry of Health, Labour and Welfare, Health Insurance Bureau, Medical Affairs Division","year":"2020"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k2438"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1611832"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610214001975"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1159\/000531240"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.5041"},{"key":"e_1_2_11_38_1","volume-title":"Dementia: Assessment, Management and Support for People Living With Dementia and Their Carers NG97","author":"National Institute for Health and Care Excellence (NICE)","year":"2018"},{"key":"e_1_2_11_39_1","volume-title":"Community\u2010Based Integrated Care in Japan: Suggestions for Developing Countries From Cases in Japan","author":"Cabinet Office, Government of Japan","year":"2022"},{"key":"e_1_2_11_40_1","volume-title":"Health at a Glance 2021: OECD Indicators","author":"Organization for Economic Co\u2010operation and Development","year":"2021"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.14600"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0129366"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2023.105111"}],"container-title":["Geriatrics &amp; Gerontology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ggi.70824","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ggi.70824","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ggi.70824","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:32:20Z","timestamp":1790231540000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ggi.70824"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":42,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/ggi.70824"],"URL":"https:\/\/doi.org\/10.1111\/ggi.70824","archive":["Portico"],"relation":{},"ISSN":["1444-1586","1447-0594"],"issn-type":[{"value":"1444-1586","type":"print"},{"value":"1447-0594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-04-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70824"}}