{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T16:03:58Z","timestamp":1783181038219,"version":"3.54.6"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T00:00:00Z","timestamp":1641168000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T00:00:00Z","timestamp":1641168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Japan has promoted end-of-life care at home and in long-term care facilities, and the total proportion of in-hospital deaths has decreased recently. However, the difference in trends of in-hospital deaths by the cause of death remains unclear. We investigated the variation in trends of in-hospital deaths among older adults with long-term care from 2007 to 2017, by cause of death and place of care.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Using the national long-term care insurance registry, long-term care claims data, and national death records, we identified people aged 65\u2009years or older who died between 2007 and 2017 and used long-term care services in the month before death. Using a joinpoint regression model, we evaluated time trends of the proportion of in-hospital deaths by cause of death (cancer, heart diseases, cerebrovascular diseases, pneumonia, and senility) and place of care (home, long-term care health facility, or long-term care welfare facility).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the 3,261,839 participants, the mean age was 87.0\u2009\u00b1\u20098.0\u2009years, and 59.2% were female. Overall, the proportion of in-hospital deaths decreased from 66.2% in 2007 to 55.3% in 2017. By cause of death, the proportion of in-hospital deaths remained the highest for pneumonia (81.6% in 2007 and 77.2% in 2017) and lowest for senility (25.5% in 2007 and 20.0% in 2017) in all types of places of care. The joinpoint regression analysis showed the steepest decline among those who died of senility, especially among long-term care health facility residents.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The findings of this nationwide study suggest that there was a decreasing trend of in-hospital deaths among older adults, although the speed of decline and absolute values varied widely depending on the cause of death and place of care.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12877-021-02700-1","type":"journal-article","created":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T10:05:23Z","timestamp":1641204323000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["National trends in the proportion of in-hospital deaths by cause of death among older adults with long-term care: a nationwide observational study in Japan from 2007 to 2017"],"prefix":"10.1186","volume":"22","author":[{"given":"Yuta","family":"Taniguchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masao","family":"Iwagami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueying","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuo","family":"Sakata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikiya","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taeko","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoko","family":"Hanari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Abe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruko","family":"Noguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanako","family":"Tamiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,3]]},"reference":[{"key":"2700_CR1","unstructured":"World Health Organization. World report on ageing and health. 2015. https:\/\/apps.who.int\/iris\/handle\/10665\/186463. Accessed 14 Oct 2021."},{"issue":"1","key":"2700_CR2","doi-asserted-by":"publisher","first-page":"67","DOI":"10.31662\/jmaj.2018-0015","volume":"2","author":"M Iwagami","year":"2019","unstructured":"Iwagami M, Tamiya N. The long-term care insurance system in Japan: past, present, and future. JMA J. 2019;2(1):67\u20139.","journal-title":"JMA J"},{"key":"2700_CR3","unstructured":"Ministry of Health, Labour and Welfare, Japan. Vital statistics of Japan. 2019. https:\/\/www.mhlw.go.jp\/english\/database\/db-hw\/index.html. Accessed 14 Oct 2021."},{"issue":"24","key":"2700_CR4","doi-asserted-by":"publisher","first-page":"2369","DOI":"10.1056\/NEJMc1911892","volume":"381","author":"SH Cross","year":"2019","unstructured":"Cross SH, Warraich HJ. Changes in the place of death in the United States. N Engl J Med. 2019;381(24):2369\u201370.","journal-title":"N Engl J Med"},{"key":"2700_CR5","unstructured":"Cabinet Office Japan. Koureisha no kenko ni kansuru ishikichosakekka. 2012. https:\/\/www8.cao.go.jp\/kourei\/ishiki\/h24\/sougou\/zentai\/index.html. Accessed 14 Oct 2021."},{"key":"2700_CR6","unstructured":"National Institute of Population and Social Security Research. Population projections for Japan. 2017. http:\/\/www.ipss.go.jp\/pp-zenkoku\/j\/zenkoku2017\/pp_zenkoku2017.asp. Accessed 14 Oct 2021. In Japanese."},{"key":"2700_CR7","unstructured":"Ministry of Health, Labour and Welfare, Japan. Shinryohoshu to kaigohoshu no doujikaitei ni mukete (shiryo 1). 2011. https:\/\/www.mhlw.go.jp\/stf\/shingi\/2r9852000001rbxs.html. Accessed 14 Oct 2021. In Japanese."},{"key":"2700_CR8","unstructured":"Ohta H. Chiiki houkatsu keashisutemu (community-based integrated care system). Nakayama Shoten. 2016;1:245. 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All methods were performed in accordance with the relevant guidelines and regulations. Consent to participate was waived as we used anonymized claims data and national death records.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"6"}}