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New health technologies are as the state-of-the-art in the modern medicine and health care that can be applied to various systemic diseases. Regardless of its importance, in many cases the patients are not being able to benefit from new health technologies for their systemic diseases. Hence, they are not covered under health insurance generally, and even covered, it is common that long time is taken to be covered. This study looks at different perspective to the number of previous studies on regenerative medicine as an exemplary case and health insurance coverage, which focused on the clinical results that was beneficial to the patients, researchers and society. In this study, the insured benefits and various non-insured benefits under the health insurance system were examined. Even some regenerative medical services are recognized as safety and efficacy to some degree, the problem of being treated as non-insured medical services due to the new health care technology as itself was discussed through the concept of shadow price. In addition, the study discussed that regenerative medicine proven effectiveness for disease treatments should be included in the insurance benefits, in principle. For this, Japanese cases were referred. The case of Japan may not be fully applicable to all other countries or some specific countries. However, it may be a reference for countries with low protection even though taking public medical insurance systems. [ABSTRACT FROM AUTHOR]

Background: Medical care and long-term care utilization in the last year of life of frail older adults could be a key indicator of their quality of life. This study aimed to identify the medical care expenditure (MCE) trajectories in the last year of life of frail older adults by investigating the association between MCE and long-term care utilization in each trajectory. Methods: The retrospective cohort study of three municipalities in Japan included 405 decedents (median age at death, 85 years; 189 women [46.7%]) from a cohort of 1,658 frail older adults aged ≥65 years who were newly certified as support level in the long-term care insurance program from April 2012 to March 2013. This study used long-term care and medical insurance claim data from April 2012 to March 2017. The primary outcome was MCE over the 12 months preceding death. Group-based trajectory modeling was conducted to identify the MCE trajectories. A mixed-effect model was employed to examine the association between long-term care utilization and MCE in each trajectory. Results: Participants were stratified into four groups based on MCE trajectories over the 12 months preceding death as follows: rising (n = 159, 39.3%), persistently high (n = 143, 35.3%), minimal (n = 56, 13.8%), and descending (n = 47, 11.6%) groups. Home-based long-term care utilization was associated with increased MCE in the descending trajectory (coefficient, 1.48; 95% confidence interval [CI], 1.35–1.62). Facility-based long-term care utilization was associated with reduced MCE in the rising trajectory (coefficient, 0.59; 95% CI, 0.50–0.69). Both home-based (coefficient, 0.92; 95% CI, 0.85–0.99) and facility-based (coefficient; 0.53; 95% CI, 0.41–0.63) long-term care utilization were associated with reduced MCE in the persistently high trajectory. Conclusions: These findings may facilitate the integration of medical and long-term care models at the end of life in frail older adults. [ABSTRACT FROM AUTHOR]

Simple Summary: Lockdowns and health service disruptions during the COVID-19 pandemic led to concerns about a potential decrease in essential health screenings, even after the pandemic. It is crucial to understand how the pandemic affected women's participation in breast cancer screenings in Japan and whether getting the COVID-19 vaccine influenced their participation rates. We analyzed data from over 6110 women aged 40 to 74 years from a large online survey conducted in 2021 and 2022. Our findings showed that the number of women getting screened for breast cancer did not decrease after the pandemic. Moreover, women who were vaccinated against COVID-19 were more likely to attend their screenings compared to those who were not vaccinated. This result aligns with the observation that vaccinated individuals tend to be more proactive about their health. There is limited information on whether the COVID-19 pandemic was associated with decreased breast cancer screening uptake and if COVID-19 vaccination was associated with an increase in screening uptake. Our study explored the uptake of breast cancer screening in Japan after the COVID-19 pandemic and assessed its association with the COVID-19 vaccination. We analyzed data from the Japan COVID-19 and Society Internet Survey (JACSIS), a web-based prospective cohort survey, and we included 6110 women without cancer history who were aged 40 to 74 years that participated in the 2012 and 2022 surveys. We examined the regular breast cancer screening uptake before and after the pandemic and employed a multivariable Poisson regression model to seek any association between COVID-19 vaccination and screening uptake. Of 6110, 38.2% regularly participated in screening before the pandemic and 46.9% did so after the pandemic. Individuals unvaccinated due to health reasons (incidence rate ratio (IRR) = 0.47, 95% CI: 0.29–0.77, p = 0.003) and for other reasons (IRR = 0.73, 95% CI: 0.62–0.86, p < 0.001) were less likely to undergo screening compared to fully vaccinated individuals. There was no long-term decrease in breast cancer screening uptake after the pandemic in Japan. Vaccination was linked to increased uptake, but there was no dose relationship. [ABSTRACT FROM AUTHOR]