Background: Long-term care facilities for older people play an important role as alternatives to family care in an aging society. This study aimed to assess staffing problems linked to emergency healthcare for residents of these facilities, and to investigate the relationship between these problems and the characteristics of the facilities. Methods: The study surveyed managers of long-term care facilities for older people in a Japanese urban area between September and December 2014. The type of care facility, the number of staff and any problems providing or accessing emergency healthcare for the residents were evaluated. Multiple logistic regression analysis was used to explore the factors common to facilities reporting staffing problems linked to emergency healthcare of residents. Results: In total, 321 long-term care facilities were eligible for this study and 226 (70%) returned the questionnaire. We compared the characteristics of facilities reporting and not reporting staffing problems in emergency healthcare of residents. The type of care facility was significantly associated with staffing problems in emergency healthcare of residents both during the day (p < 0.01) and at night (p = 0.04). The facilities most likely to report problems were group homes for older people with dementia, because of staffing shortages. Conclusions: Problems in emergency healthcare systems in Japanese long-term care facilities for older people varied by type of care facility. Our data underscore the need for telemedicine and consideration of mergers between smaller facilities such as group homes for older people with dementia.
Hemodialysis patients in Japan are aging and thus more patients need support for attending hemodialysis facilities. This study aimed to clarify how dialysis patients utilize the services covered by Japan's public long-term care insurance (LTCI) system. This cross-sectional study was based on LTCI data of March 31, 2009, the latest available data provided by Niigata City, located on the northwest coast of Honshu. Among 30,349 LTCI users in Niigata City, there were 234 dialysis patients. To clarify the characteristics of the dialysis patients, we compared the utilization of LTCI services between the dialysis patients (234 users) and randomly selected 765 non-dialysis users. We also calculated the annual transportation service costs per patient for dialysis patients who continued home care (home care group) and those who switched to longterm hospital care at LTCI care levels 4 and 5 (hospital admission group). These care levels indicate difficulty in walking or maintaining a sitting posture without assistance. The dialysis group more frequently utilized home care and equipment services, such as renting or purchasing care-support products and support for home equipment repair, and utilized facility services and short-stay services (respite care) less frequently (both p < 0.001). Cost per patient was higher in the home care group than in the hospital admission group, because the transportation services for dialysis patients at care levels 4 and 5 involve higher costs. These findings indicate that LTCI services usable for dialysis patients were limited. Therefore, instead of merely subsidizing transportation expenses, transportation services must be improved.
The hospital environment in Japan has changed drastically lately. Its unpredictability has increased the need for hospitals to select management strategies to clarify their course. However, research on Japanese hospitals' management strategies has only recently begun with too few studies in this area. Hence, this study clarifies the management strategies of Japanese private hospitals. It explores the hospital characteristics that affect strategy selection. A questionnaire was mailed to 5682 private medical institutions in 2013, and 459 responses with no missing data were used for analysis. Factor analysis yielded four factors: "bed conversion and downsizing (Factor 1)," "diversification of medical and nursing care (Factor 2)," "expansion in business scale (Factor 3)," and "expansion of income from non-insured medical care (Factor 4)". Logistic regression analysis revealed that Year Founded (before 1965), Hospital Location (municipalities with populations smaller than 100,000), Hospital Type (psychiatric hospitals and mixed-care hospital), and Hospital Income and Expenditure (deficit) had significant positive impacts on the choice of Factor 1. For Factor 2, Hospital Type (sanatorium ward and mixed-care hospitals) and Hospital Income and Expenditure (constant surplus) had positive impacts. For Factor 3, Hospital Type (general hospital) and Bed Counts (more than 200) had positive impacts. For Factor4, Hospital Type (general hospital) had positive impacts. In other words, older hospitals, hospitals in rural areas, psychiatric hospitals, mixed-care hospitals, and hospitals with deficits tended to choose bed conversion and downsizing. Sanatorium ward hospitals, mixed-care hospitals, and hospitals with a constant surplus tended to choose 1495 Health diversification of medical and nursing care. General hospitals and large hospitals tended to choose expansion in scale, and general hospitals tended to choose expansion into non-insured medical care. The planning of mid-to long-term management strategies suitable for each hospital and their steady execution are required.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.