Relationship between home care service use and changes in the care needs level of Japanese elderly

Kato, Go; Tamiya, Nanako; Kashiwagi, Masayo; Sato, Mikiya; Takahashi, Hideto

doi:10.1186/1471-2318-9-58

Cited by 49 publications

(70 citation statements)

References 33 publications

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“…Eligibility for the LTCI is strictly determined by municipalities according to the extent of the physical and mental disability. Seven levels of long‐term care‐need certificates were established beginning with support levels 1 or 2, which are intended to provide preventive services; care‐need level 1 comprises users who are less disabled, and care‐need level 5 comprises users who are most disabled . The certificate is available for a maximum of 2 years (1 year in principle) for persons who renew the certificates, and a maximum of 1 year (6 months in principle) for new LTCI users.…”

Section: Methodsmentioning

confidence: 99%

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Resident and facility characteristics associated with care‐need level deterioration in long‐term care welfare facilities in Japan

Jin

Tamiya

Jeon

et al. 2018

Geriatrics Gerontology Int

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Aim: To determine the resident and facility characteristics associated with residents' care-need level deterioration in long-term care welfare facilities in Japan.Methods: A nationally representative sample of 358 886 residents who lived in 3774 long-term care welfare facilities for at least 1 year from October 2012 was obtained from long-term care insurance claims data. Facility characteristics were linked with a survey of institutions and establishments for long-term care in 2012. We used a multilevel logistic regression according to the inclusion and exclusion of lost to follow-up to define the resident and facility characteristics associated with resident care-need level deteriorations (lost to follow-up: the majority were hospitalized residents or had died; were treated as deterioration in the including loss to follow-up model).Results: Adjusting for the covariates, at the resident level, older age and lower care-need level at baseline were more likely to show deterioration in the care-need level. At the facility level, metropolitan facilities, unit model (all private room settings) and mixed-model facilities (partly private room settings) were less likely to experience careneed level deterioration. A higher proportion of registered nurses among all nurses was negatively related to careneed level deterioration only in the model including lost to follow-up. A higher proportion of registered dietitians among all dietitians and the facilities in business for fewer years were negatively associated with care-need level deterioration only in the model excluding lost to follow-up. Conclusions:The present study could help identify residents who are at risk of care-need level deterioration, and could contribute to improvements in provider quality performance and enhance competence in the market. Geriatr Gerontol Int 2018; 18: 758-766.

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Section: Methodsmentioning

confidence: 99%

“…The age (65–74, 75–84, 85–94, >95 years) at baseline and sex were collected . This study used the care‐need level at baseline to adjust the residents’ health status …”

Section: Methodsmentioning

confidence: 99%

Resident and facility characteristics associated with care‐need level deterioration in long‐term care welfare facilities in Japan

Jin

Tamiya

Jeon

et al. 2018

Geriatrics Gerontology Int

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“…Then, we stratified the six care levels into lower care-needs level subgroups (care support level or care needs level 1-2) and higher care-needs level subgroups (care needs level 3 and 5). Kato [17] also used this categorizing strategy.…”

Section: Methodsmentioning

confidence: 99%

Factors associated with the use of home-visit nursing services covered by the long-term care insurance in rural Japan: a cross-sectional study

et al. 2013

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BackgroundIn Japan, there is a large increase in the number of elderly persons who potentially need home-visit nursing services (VNS). However, the number of persons using the VNS has increased only little in comparison to the number of individuals who use home social services, which are also covered by the Long-Term Care Insurance (LTCI) system. This cross-sectional study investigated the predictors of the VNS used under the LTCI system in Japan.MethodsWe used 1,580 claim data from all the users of community-based services and 1,574 interview survey data collected in 2001 from the six municipal bodies in Japan. After we merged the two datasets, 1,276 users of community-based services under the LTCI were analyzed. Multiple logistic regression models stratified by care needs levels were used for analysis.ResultsOnly 8.3% of the study subjects were VNS users. Even among study participants within the higher care-needs level, only 22.0% were VNS users. In the lower care level group, people with a higher care level (OR: 3.50, 95% CI: 1.50–8.93), those whose condition needed long term care due to respiratory or heart disease (OR: 4.31, 95% CI: 1.88–89.20), those whose period of needing care was two years or more (OR: 2.01, 95% CI: 1.14–3.48), those whose service plan was created by a medical care management agency (OR: 2.39, 95% CI: 1.31–4.33), those living with family (OR: 1.86, 95% CI: 1.00–3.42), and those who use home-help services (OR: 2.12, 95% CI: 1.17–3.83) were more likely to use the VNS. In the higher care level group, individuals with higher care level (OR: 3.63, 95% CI: 1.56–8.66), those with higher income (OR: 3.79, 95% CI: 1.01–14.25), and those who had regular hospital visits before entering the LTCI (OR: 2.36, 95% CI: 1.11–5.38) were more likely to use the VNS.ConclusionsOur results suggested that VNS use is limited due to management by non-medical care management agencies, due to no caregivers being around or a low income household. The findings of this study provide valuable insight for LTCI policy makers: the present provision of VNS should be reconsidered.

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“…This analysis was made because in some previous studies [20,22,24], observations of the effect of each home and community-based service on eligibility level were limited to individuals certified as having light need for long-term care.…”

Section: Methodsmentioning

confidence: 99%

Impact of home and community-based services on hospitalisation and institutionalisation among individuals eligible for long-term care insurance in Japan

Tomita

Yoshimura

Ikegami

2010

BMC Health Serv Res

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BackgroundThis population-based retrospective cohort study aimed to clarify the impact of home and community-based services on the hospitalisation and institutionalisation of individuals certified as eligible for long-term care insurance (LTCI) benefits.MethodsHealth insurance data and LTCI data were combined into a database of 1,020 individuals in two farming communities in Hokkaido who were enrolled in Citizen's Health Insurance. They had not received long-term care services prior to April 1, 2000 and were newly certified as eligible for Long-Term Care Insurance benefits between April 1, 2000 and February 29, 2008. The analysis covered 565 subjects who had not been hospitalised or institutionalised at the time of first certification of LTCI benefits. The adjusted hazard ratios (HRs) of hospitalisation or institutionalisation or death after the initial certification were calculated using the Cox proportional hazard model. The predictors were age, sex, eligibility level, area of residence, income, year of initial certification and average monthly outpatient medical expenditures, in addition to average monthly total home and community-based services expenditures (analysis 1), the use or no use of each type of service (analysis 2), and average monthly expenditures for home-visit and day-care types of services, the use or no use of respite care, and the use or no use of rental services for assistive devices (analysis 3).ResultsUsers of home and community-based services were less likely than non-users to be hospitalised or institutionalised. Among the types of services, users of respite care (HR: 0.71, 95% confidence interval [CI]: 0.55-0.93) and rental services for assistive devices (HR: 0.70, 95% CI: 0.54-0.92) were less likely to be hospitalised or institutionalised than non-users. For those with relatively light needs, users of day care were also less likely to be hospitalised or institutionalized than non-users (HR: 0.77, 95% CI: 0.61-0.98).ConclusionsRespite care, rental services for assistive devices and day care are effective in preventing hospitalisation and institutionalisation. Our results suggest that home and community-based services contribute to the goal of the LTCI system of encouraging individuals certified as needing long-term care to live independently at home for as long as possible.

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Relationship between home care service use and changes in the care needs level of Japanese elderly

Cited by 49 publications

References 33 publications

Resident and facility characteristics associated with care‐need level deterioration in long‐term care welfare facilities in Japan

Resident and facility characteristics associated with care‐need level deterioration in long‐term care welfare facilities in Japan

Factors associated with the use of home-visit nursing services covered by the long-term care insurance in rural Japan: a cross-sectional study

Impact of home and community-based services on hospitalisation and institutionalisation among individuals eligible for long-term care insurance in Japan

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