Validating care‐needs level against self‐reported measures of functioning, disability and sarcopenia among Japanese patients receiving home medical care: The Zaitaku Evaluative Initiatives and Outcome Study

Abstract

Aim This study aimed to examine the validity of the care‐needs levels classified in Japan's long‐term care insurance system (LTCI‐CNLs) when compared with patients’ self‐perceived functioning, disability and physical performance among patients receiving home medical care. Methods This was a multicenter cross‐sectional study in Japan. Patients who were receiving continuous home medical care and who could respond to the questionnaire were enrolled in this study. In addition to the LTCI‐CNLs, the 12‐item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and the SARC‐F were used to measure functioning, disability and physical performance (sarcopenia). In addition, correlations and associations of the LTCI‐CNLs with the WHODAS 2.0 and SARC‐F were analyzed using Spearman correlations and linear mixed models. Results Data from 181 patients were included in the analyses. The LTCI‐CNLs varied, ranging from support level 1 (5.5%) to care‐needs level 5 (10.5%), with care‐needs level 2 being the most prevalent (24.9%). Moderate correlations of the LTCI‐CNLs with the WHODAS 2.0 and SARC‐F were found (ρ = 0.58 and 0.44, respectively). Although WHODAS 2.0 and SARC‐F scores varied within each LTCI‐CNL, predicted WHODAS 2.0 and SARC‐F scores increased as LTCI‐CNL increased. Dementia was not associated with WHODAS 2.0 or SARC‐F. Conclusions The LTCI‐CNLs was associated with self‐reported functioning, disability and physical performance among home medical care patients. Future studies can use the LTCI‐CNLs as an outcome variable for specific care approaches or as a proxy covariate for casemix status. Geriatr Gerontol Int 2021; 21: 229–237.

Comparison of Japanese Centenarians’ and Noncentenarians’ Medical Expenditures in the Last Year of Life

“…This assessment is then reviewed and finalized by an expert committee consisting of experts in health and social services who are appointed by a mayor. 63 , 64 , 65 , 66 We applied the most severe care needs level for each targeted patient during each study period as an independent variable.…”

Screening Tools for Sarcopenia

“…There is a study called the ZEVIOUS study that examines the validity of classifying the level of nursing care in home health care patients based on subjective measures of daily function and sarcopenia. In this study, the relationship between the level of nursing care and self-reported daily living and physical functions in 181 patients receiving home health care was cross-sectionally analyzed (38). In the results, the level of nursing care varied, ranging from support level 1 (5.5%) to care-needs level 5 (10.5%), with care-needs level 2 being the most prevalent (24.9%).…”

“…Lifestyle function was assessed with the World Health Organization Disability Assessment Schedule (WHODAS2.0), which reflects the International Classification of Functioning, Disability and Health (ICF), and physical function was assessed with the SARC-F. The higher the level of nursing care, the lower the level of self-reported life and physical functioning (38). Therefore, the level of nursing care and the SARC-F are significantly positively correlated.…”

Assessment of sarcopenia and malnutrition using estimated GFR ratio (eGFRcys/eGFR) in hospitalised adult patients

“…Sarcopenia is associated with impairment of activities of daily living (ADL) [1] and instrumental ADL [2], resulting in the requirement of long-term care [3] and impairment of quality of life [4].…”