Key result
Current Japanese palliative care fee criteria capture only ~47% of end-of-life or refractory HF hospitalizations.
Observational (n=39)
No
More than half of endstage heart failure hospitalizations with refractory symptoms or end-of-life care needs in Japan do not meet current eligibility criteria for the palliative care fee, primarily due to the strict repeated-hospitalization requirement.
Japanese palliative care eligibility criteria for end-stage HF may under-identify refractory cases; leaves open whether revised criteria would improve integration.
Background: International guidelines recommend integrating palliative care into heart failure (HF) management. In Japan, the additional medical fee for palliative care became applicable to endstage HF in 2018, but its adoption has remained very low, so we examined how well the current eligibility criteria capture HF hospitalizations with refractory symptoms or end-of-life care needs.
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Okabe et al. (2026) conducted an observational in Endstage Heart Failure (n=39). Current eligibility criteria for the additional medical fee for palliative care was evaluated on Proportion of HF hospitalizations with refractory symptoms or end-of-life care needs that met the eligibility criteria for the additional medical fee for palliative care (95% CI 30.8-61.7). Only 46.5% of heart failure hospitalizations with refractory symptoms or end-of-life care needs met the current eligibility criteria for the additional medical fee for palliative care in Japan.
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