Worsening Health Status among Evacuees: Analysis of Medical Expenditures after the 2011 Great East Japan Earthquake and Nuclear Disaster in Fukushima

Hasegawa, Makoto; Murakami, Michio; Nomura, Shuhei; Takebayashi, Yoshitake; Tsubokura, Masaharu

doi:10.1620/tjem.248.115

Cited by 8 publications

(11 citation statements)

References 17 publications

(26 reference statements)

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“…Previous studies have shown that the LTC costs for residents over 65 years in the former evacuation areas in Fukushima prefecture were approximately 1.5 times higher in 2012-2014 than before the earthquake. 3,6 This was caused by a marked increase in the utilization ratio of mild-degree LTC presumably due to the loss of informal at-home care. Currently, there is not enough information on whether the loss of informal care is more prominent in the evacuee or returnee groups hence, more information on family members is needed to properly understand the health care needs of those living in former evacuation areas.…”

Section: Discussionmentioning

confidence: 99%

Long-term Care Utilization Discrepancy Among the Elderly in Former Evacuation Areas, Fukushima

Kobashi

Morita

Ozaki

et al. 2021

Disaster med. public health prep.

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Objective: It is crucial to determine the health status of returnees to former evacuation areas. We aimed to examine the long-term care (LTC) utilization rate among elderly returnees as the indicator of care needs. Methods: This study used a resident registration database to collect information on LTC utilization rate among elderly returnees to former evacuation areas in Fukushima, Japan, following the 2011 Fukushima Daiichi Nuclear Power Plant accident. LTC utilization rates were descriptively analyzed. Results: For all age groups, the LTC utilization rates were lower among returnees than evacuees. The LTC utilization rate among returnees in each age group (chi-square test results compared to evacuees) were as follows: 0.78% (P = 0.194) for those aged 65–69, 0.69% (P = 0.003) for those aged 70–74, 3.23% (P = 0.007) for those aged 75–79, 6.79% (P < 0.001) for those aged 80–84, 22.84% (P = 0.011) for those aged 85–89, and 44.09% (P = 0.089) for those aged 90 and over. Conclusion: Elderly returnees had fewer LTC needs than elderly evacuees. Nevertheless, the proportion of aging people is high in evacuation area, meaning the number of elderly returnees would increase at an enormous rate. Therefore, LTC utilization rate would increase in the future.

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Section: Discussionmentioning

confidence: 99%

Long-term Care Utilization Discrepancy Among the Elderly in Former Evacuation Areas, Fukushima

Kobashi

Morita

Ozaki

et al. 2021

Disaster med. public health prep.

Self Cite

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“…Ueda et al (2019) used the data for evacuees of the nuclear power plant accident and identified that insufficient sleep and heavy drinking (≥ 4 drinks per day) were significant risk factors for the incidence of problem drinking in both men and women. Hasegawa et al (2019) revealed the increases in healthcare and long-term care expenditure, possibly because of the poor health status of the evacuees following the evacuations, reduced availability of informal care provided by family members and neighbors, and reduced patient copayments. The recovery and reconstruction are still on-going after GEJE.…”

Section: Articles Related With Geje In Tjem After 2011mentioning

confidence: 99%

Progress of Disaster Medicine during Ten Years after the 2011 Great East Japan Earthquake

Egawa

2021

Tohoku J. Exp. Med.

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The 2011 Great East Japan Earthquake (GEJE) has renewed the paradigm of disaster medicine. The Tohoku Journal of Experimental Medicine (TJEM) widened its scope to include the disaster science from the health perspectives. TJEM has been accumulating 76 articles related with "disaster" or "pandemic" out of which 69 were published after 2011. Tohoku University established the International Research Institute of Disaster Science (IRIDeS) that took initiative to impact the Sendai Framework for Disaster Risk Reduction 2015-2030 (Sendai Framework) to include health aspect. Sendai Framework provided the platform for collaboration of different sectors, including the terminology that defines the concept of disaster, risk, hazard & exposure, vulnerability and coping capacity. Disaster medicine covers the diverse causes and damages of disasters by various hazards in this globalized and rapidly changing world. TJEM articles range the physical and mental health damage after the GEJE and other disasters with approved ethical consideration of investigations from the view point of affected area, mechanisms of hazard to affect human health including the radiation, virus or hazardous materials, proposal of refinement of health system to cope with disasters such as mental health support, risk communication, disaster medical coordination and hospital business continuity plan and future perspectives with reconstruction including Tohoku Medical Megabank Project. TJEM scope on disaster medicine had been widened during the 10 years after GEJE and IRIDeS can be the bridging hub not only between the health sector and other sectors, but also between disaster medicine and other medical disciplines.

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“…A systematic review revealed psychological burdens such as a deterioration in mental health [21] and an increase in prevalence of post-traumatic stress disorder (PTSD) [22], as well as deterioration in health due to living in an evacuation center or a worse living environment [23], an increase in frailty risk [24], spread of pneumonia [25], and an increase in the number of people with subjective symptoms such as gastrointestinal and/or musculoskeletal symptoms [26].…”

Section: Factors Causing Increase In Long-term Care Certification Ratmentioning

confidence: 99%

“…Disaster survivors, and especially those aged 75 years or older, sustained not only direct injuries from the earthquake, but also deterioration in their living environments and psychological effects such as PTSD, as mentioned earlier. Informal care from family and others also declined [23], resulting in activity limitations. Together, these may have led to an increase in long-term care requirements for those with minor and medium need.…”

Section: Factors Causing Increase In Long-term Care Certification Ratmentioning

confidence: 99%

Did the Number of Older People Requiring Long-Term Care and Expenditure Increase after the 2011 Great East Japan Earthquake? Analysis of Changes over Six Years

Inoue

Jeong

2020

IJERPH

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On 11 March 2011, the great earthquake hit Japan, resulting in 15,895 deaths, 6156 serious injuries, and 2539 missing persons. This event affected the health and lives of older residents, and reports showed an increase in the number of people eligible for long-term care afterward. In this study, among the places affected by the 2011 Great East Japan Earthquake and tsunami, we focused on 15 municipalities, including designated municipalities based on the Special Act on Nuclear Evacuation in Fukushima Prefecture, and aimed to clarify the medium-term effects (six years post-disaster) on the long-term care certification rate and expenditure for provision of services. We used the Ministry of Health, Labour, and Welfare Monthly Status Report on Long-Term Care Insurance and the Ministry of Internal Affairs and Communications Population Register for 2011, 2014, and 2017. In 2011, we found no intergroup differences among the 15 Fukushima municipalities and other municipalities in either the long-term care certification rate or the per-person expenditure for use of services. In 2014, after the earthquake, the long-term care certification rate was 5.4% higher in the 15 Fukushima municipalities than in other municipalities for those aged 75 years or older. The rate of 2014–2017 has not increased significantly, partly because of stability after the disaster and change in the population structure. Nevertheless, the long-term care certification rate in the 15 Fukushima municipalities is higher than that of the other two groups even after six years since the earthquake. Similarly, the per-person expenditure for use of services for one month was 11,800 yen higher in the 15 Fukushima municipalities than in other municipalities in 2014, and this trend continued into 2017. Strong, ongoing governmental support is needed, especially for those aged 75 or older, following a disaster.

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Worsening Health Status among Evacuees: Analysis of Medical Expenditures after the 2011 Great East Japan Earthquake and Nuclear Disaster in Fukushima

Cited by 8 publications

References 17 publications

Long-term Care Utilization Discrepancy Among the Elderly in Former Evacuation Areas, Fukushima

Long-term Care Utilization Discrepancy Among the Elderly in Former Evacuation Areas, Fukushima

Progress of Disaster Medicine during Ten Years after the 2011 Great East Japan Earthquake

Did the Number of Older People Requiring Long-Term Care and Expenditure Increase after the 2011 Great East Japan Earthquake? Analysis of Changes over Six Years

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