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ration number CRD42020202094. Additional payment approach has been one of the most important incentives in long-term care (LTC) systems for the past 20 years in Japan. To estimate the effect of additional payments on functional decline in long-term care health facility (LTCHF) residents of Japan. A 24-month retrospective cohort study. Residents aged ≥65years who were newly admitted to LTCHFs in the 2014 fiscal year. National LTC claims data were linked to the survey of institutions and establishments for LTC. Competing risk regression was
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