Association Between Advanced Care Management and Progression of Care Needs Level in Long-Term Care Recipients: Retrospective Cohort Study

BACKGROUND Long-term care insurance systems in Japan started a special senior care program overseen by qualified care managers (also known as advanced care managers). However, the relationship between advanced care management and outcomes in long-term care recipients remains unknown. OBJECTIVE We aimed to compare the outcome of long-term care recipients using facilities with advanced care management and conventional care management, in terms of care needs level progression. METHODS We conducted a retrospective cohort study using the Survey of Long-Term Care Benefit Expenditures in Japan. We identified those aged ≥65 years who were newly designated a care need level of 3, and received long-term care services between April 2009 and March 2014 in Tokyo. We compared survival without progression of care needs level between the groups, with and without advanced care management, using the Kaplan-Meier method. Factors affecting the outcomes were determined using a multivariable logistic regression model fitted with a generalized estimating equation. RESULTS Of 45,330 eligible persons, 12,903 (28.46%) received long-term care based on advanced care management. The average duration of progression-free survival was 17.4 (SD 10.2) months. The proportions of five-year cumulative progression-free survival were 41.2% and 32.8% in those with and without advanced care management, respectively. The group with advanced care management had significantly lower care needs levels (odds ratio 0.77, 95% CI, 0.72-0.82, P<.001). CONCLUSIONS Advanced care management was significantly associated with improved care needs levels.

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Impact of B.1.351 (beta) SARS-CoV-2 variant on BNT162b2 mRNA vaccine effectiveness in long-term care facilities of eastern France: a retrospective cohort study

10.1101/2021.07.28.21261285 ◽

2021 ◽

Author(s):

Benjamin Lefevre ◽

Laura Tondeur ◽

Yoann Madec ◽

Rebecca Grant ◽

Bruno Lina ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Long Term Care ◽

Multivariable Analysis ◽

Winter Season ◽

Vaccine Effectiveness ◽

Term Care ◽

Care Facilities

Abstract Background: We aimed to assess the effectiveness of the BNT162b2 mRNA vaccine against B.1.351 (beta) variant among residents of long-term care facilities (LCTFs) in eastern France. Methods: We used routinely collected surveillance and COVID-19 vaccination data to conduct a retrospective cohort study of SARS-CoV-2 B.1.351 infection incidence and vaccine effectiveness among LCTFs residents in eastern France between 15 January and 19 May 2021. Data from secondary RT-PCR screening were used to identify B.1.351 variants. Findings: Included in our analysis were 378 residents from five LCTFs: 287 (76%) females, with median (IQR) age of 89 (83-92) years. Two B.1.351 outbreaks took place in LTCFs in which more than 70% of residents had received two doses of BNT162b2 mRNA vaccine, which included 11 cases of severe disease and six deaths among those who had received two doses. Vaccine effectiveness (95% CI) seven days after the second dose of vaccine was 49% (14-69) against any infection with B.1.351 and 86% (67-94) against severe forms of COVID-19. In multivariable analysis, females were less likely to develop severe forms of disease (IRR = 0.35, 95% CI = 0.20-0.63). Interpretation: We observed reduced vaccine effectiveness associated with B.1.351, as well as B.1.351 outbreaks in two LTCFs among individuals who had received two doses of vaccine. Our findings highlight the need to maintain SARS-CoV-2 surveillance in these high-risk settings beyond the current COVID-19 mass vaccination campaign, and advocate for a booster vaccine dose prior to the next winter season.

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Risk factors for pneumonia and influenza hospitalizations in long-term care facility residents: a retrospective cohort study

BMC Geriatrics ◽

10.1186/s12877-020-1457-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Patience Moyo ◽

Andrew R. Zullo ◽

Kevin W. McConeghy ◽

Elliott Bosco ◽

Robertus van Aalst ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Long Term Care ◽

Care Facility ◽

Term Care ◽

Term Care Facility ◽

Long Term Care Facility

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491. Clinical Manifestations and Outcomes of Clostridium difficile Infection in Long-Term Care Patients: An 8-Year Retrospective Cohort Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.500 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S182-S182

Author(s):

Suganya Chandramohan ◽

Amar Krishna ◽

Parminder Virdi ◽

Jordon Polistico ◽

Nikhila Thammineni ◽

...

Keyword(s):

Cohort Study ◽

Clostridium Difficile ◽

Clostridium Difficile Infection ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Long Term Care ◽

Clinical Manifestations ◽

Term Care

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Functional independence measure scores predict level of long-term care required by patients after stroke: a multicenter retrospective cohort study

Disability and Rehabilitation ◽

10.3109/09638288.2014.918195 ◽

2014 ◽

Vol 37 (4) ◽

pp. 331-337 ◽

Cited By ~ 21

Author(s):

Naoki Saji ◽

Kazumi Kimura ◽

Goro Ohsaka ◽

Yasuto Higashi ◽

Yoichi Teramoto ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Long Term Care ◽

Functional Independence Measure ◽

Functional Independence ◽

Term Care

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How Often, Where, and by Which Specialty Do Long-Term Care Home Residents Receive Specialist Physician Care? A Retrospective Cohort Study

Journal of Applied Gerontology ◽

10.1177/0733464819901255 ◽

2020 ◽

pp. 073346481990125

Author(s):

Nicole S. Shaver ◽

Julie Lapenskie ◽

Glenys A. Smith ◽

Amy T. Hsu ◽

Clare Liddy ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Long Term Care ◽

Care Home ◽

Specialist Care ◽

Term Care ◽

Physician Visits ◽

Specialist Physician

This retrospective cohort study describes the rates, location, and determinants of specialist physician visits among 257,216 long-term care (LTC) residents across 648 LTC homes in Ontario, Canada, between 2007 and 2016. Visit rates in the last year of life were calculated for a sub-cohort of residents who died in LTC between 2013 and 2016. Visits were measured per resident-year using physician billings. Over 10 years, the rate of visits to specialists outside the LTC home was consistently higher than within LTC (2.99 vs. 1.55 visits/resident-year). Residents were less likely to receive specialist care if they were older, had dementia, or lived in urban LTC homes. From 12 months before death to the last week of life, rates of specialist visits increased by 246% and 56% inside and outside of LTC, respectively. Improving access to physician specialist care in LTC homes may reduce burdensome transitions and improve resident quality of life.

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The effect of timing of oseltamivir chemoprophylaxis in controlling influenza A H3N2 outbreaks in long-term care facilities in Manitoba, Canada, 2014-2015: a retrospective cohort study

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2018.115 ◽

2018 ◽

Vol 39 (8) ◽

pp. 955-960 ◽

Cited By ~ 1

Author(s):

Davinder Singh ◽

Depeng Jiang ◽

Paul Van Caeseele ◽

Carla Loeppky

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Influenza A ◽

Long Term Care ◽

Secondary Infection ◽

Symptomatic Infection ◽

Term Care ◽

Care Facilities

ObjectiveThis study examined the effect of the timing of administration of oseltamivir chemoprophylaxis for the control of influenza A H3N2 outbreaks among residents in long-term care facilities (LTCFs) in Manitoba, Canada, during the 2014–2015 influenza season.MethodsA retrospective cohort study was conducted of all LTCF influenza A H3N2 outbreaks (n=94) using a hierarchical logistic regression analysis. The main independent variable was how many days passed between the start of the outbreak and commencement of oseltamivir chemoprophylaxis. The dependent variable was whether each person in the institution developed influenza-like illness (yes or no).ResultsDelay of oseltamivir chemoprophylaxis was associated with increased odds of infection in both univariate (t=5·41; df=51; P<·0001) and multivariable analyses (t=6·04; df=49; P<·0001) with an adjusted odds ratio of 1.3 (95% confidence interval [CI], 1·2–1·5) per day for influenza A H3N2.ConclusionsThe sooner chemoprophylaxis is initiated, the lower the odds of secondary infection with influenza in LTCFs during outbreaks caused by influenza A H3N2 in Manitoba. For every day that passed from the start of the outbreak to the initiation of oseltamivir, the odds of a resident at risk of infection in the facility developing symptomatic infection increased by 33%.

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