Current Status and Barriers to Heart Failure Care in Japanese Geriatric Health Services Facilities ― A Nationwide Cross-Sectional Survey ―
Abstract
BACKGROUND: As Japan faces a heart failure (HF) pandemic, geriatric health service facilities (GHSFs) are vital for transitional HF care from hospital to home. This study investigated HF care practices, challenges, and support needs in Japanese GHSFs. METHODS AND RESULTS: We conducted a cross-sectional web-based survey of 171 GHSFs. We analyzed current management practices, perceived difficulties, and support needs regarding HF care in GHSFs. Concerns over high medication costs for HF were the primary reason for admission refusal (49.7%). Although daily symptom assessments, including dyspnea and edema were common, weight monitoring was conducted only monthly in 50.3% of facilities. HF care infrastructure was inadequate: 99.4% of GHSFs had no specialized staff (e.g., certified HF educators), only 38.0% had access to expert consultation, and only 56.7% provided HF-specific rehabilitation. Consequently, 44.4% of representatives reported significant perceived difficulty in HF care, primarily in judging consultation timing (75.0%). Facilities reporting low/neutral satisfaction with information desired advance care planning (ACP) and consultation criteria. HF patients had significantly lower home discharge rates than the overall facility residents (median [interquartile range] 20.0% [4.1-34.6%] vs. 34.0% [19.0-49.0%]; P<0.01). CONCLUSIONS: Concerns over financial barriers, along with structural and communication barriers in GHSFs, drive admission refusals and complicate HF management, potentially limiting home discharge. Improving transitional HF care requires addressing these financial concerns, providing standardized staff education and specialized support, and bridging information gaps, specifically regarding ACP and consultation criteria, between hospitals and facilities.
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BibTeX
@article{kinugasa2026current,
title = {{Current Status and Barriers to Heart Failure Care in Japanese Geriatric Health Services Facilities ― A Nationwide Cross-Sectional Survey ―}},
author = {Yoshiharu Kinugasa and Miyuki Tsuchihashi-Makaya and Akiko Okada and Masakazu Saitoh and Isao Miyajima and Hiroshi Sakurashita and Koshiro Kanaoka and Dai Yumino and Shungo Hikoso and Koichiro Kinugawa and Kazuhiro Yamamoto and on behalf of the Research Team for the Current Status and Challenges of Recovery and Maintenance Phase Care of Cardiovascular Diseases in Japan},
journal = {Circulation Journal},
year = {2026},
month = oct,
doi = {10.1253/circj.cj-26-0558},
url = {https://www.jstage.jst.go.jp/article/circj/90/11/90_CJ-26-0558/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Current Status and Barriers to Heart Failure Care in Japanese Geriatric Health Services Facilities ― A Nationwide Cross-Sectional Survey ―
AU - Yoshiharu Kinugasa
AU - Miyuki Tsuchihashi-Makaya
AU - Akiko Okada
AU - Masakazu Saitoh
AU - Isao Miyajima
AU - Hiroshi Sakurashita
AU - Koshiro Kanaoka
AU - Dai Yumino
AU - Shungo Hikoso
AU - Koichiro Kinugawa
AU - Kazuhiro Yamamoto
AU - on behalf of the Research Team for the Current Status and Challenges of Recovery and Maintenance Phase Care of Cardiovascular Diseases in Japan
PY - 2026
DA - 2026/10/23
JO - Circulation Journal
DO - 10.1253/circj.cj-26-0558
UR - https://www.jstage.jst.go.jp/article/circj/90/11/90_CJ-26-0558/_article
AB - BACKGROUND: As Japan faces a heart failure (HF) pandemic, geriatric health service facilities (GHSFs) are vital for transitional HF care from hospital to home. This study investigated HF care practices, challenges, and support needs in Japanese GHSFs. METHODS AND RESULTS: We conducted a cross-sectional web-based survey of 171 GHSFs. We analyzed current management practices, perceived difficulties, and support needs regarding HF care in GHSFs. Concerns over high medication costs for HF were the primary reason for admission refusal (49.7%). Although daily symptom assessments, including dyspnea and edema were common, weight monitoring was conducted only monthly in 50.3% of facilities. HF care infrastructure was inadequate: 99.4% of GHSFs had no specialized staff (e.g., certified HF educators), only 38.0% had access to expert consultation, and only 56.7% provided HF-specific rehabilitation. Consequently, 44.4% of representatives reported significant perceived difficulty in HF care, primarily in judging consultation timing (75.0%). Facilities reporting low/neutral satisfaction with information desired advance care planning (ACP) and consultation criteria. HF patients had significantly lower home discharge rates than the overall facility residents (median [interquartile range] 20.0% [4.1-34.6%] vs. 34.0% [19.0-49.0%]; P<0.01). CONCLUSIONS: Concerns over financial barriers, along with structural and communication barriers in GHSFs, drive admission refusals and complicate HF management, potentially limiting home discharge. Improving transitional HF care requires addressing these financial concerns, providing standardized staff education and specialized support, and bridging information gaps, specifically regarding ACP and consultation criteria, between hospitals and facilities.
SN - 1347-4820
SN - 1346-9843
ER -