Changes in Long‐Term Care Needs, Healthcare Costs, and Mortality Risk After Transcatheter Aortic Valve Implantation in Japan: The Longevity Improvement & Fair Evidence Study
Toshiharu Sassa, Megumi Maeda, Futoshi Oda, Tomohiro Sakamoto, Haruhisa FukudaABSTRACT
Aim
Transcatheter aortic valve implantation (TAVI) is increasingly performed in older adults with severe aortic stenosis, but there is limited evidence on their post‐procedure changes in care needs, healthcare costs, and mortality risk.
Methods
This retrospective cohort study used linked medical and long‐term care (LTC) insurance claims data from 1361 patients aged ≥ 75 years who underwent TAVI in 13 Japanese municipalities. Patients were stratified into four groups by baseline certified care needs level: Independent ( n = 725), Support Level 1–2 ( n = 321), LTC Level 1–2 ( n = 208), and LTC Level 3–5 ( n = 107).
Results
Among 532 patients in the 36‐month observation cohort, 53% were independent at baseline, and approximately half of those remained independent at 36 months. Monthly total medical and LTC costs at 36 months were approximately 5 times higher in the LTC Level 3–5 group than the Independent group. The LTC Level 3–5 group also showed significantly higher all‐cause mortality (hazard ratio 3.19, 95% confidence interval 2.18–4.67).
Conclusions
Higher baseline care needs are associated with poorer outcomes and higher costs after TAVI. Incorporating care needs levels into clinical assessments may inform clinical decision‐making and resource planning in older populations.