Imai Hirohisa, Fujii Yoshinori, Fukuda Yoshiharu, Nakao Hiroyuki, Yahata Yuichiro
Department of Epidemiology, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama 351-0197, Japan.
Health Policy. 2008 Mar;85(3):349-55. doi: 10.1016/j.healthpol.2007.08.008. Epub 2007 Oct 22.
A long-term care insurance (LTCI) system was introduced in 2000 in Japan. The clarification of information on the users and the ways in which services under this system have been utilized is essential for improving the system operation. This study was conducted for the purpose of clarifying what level of health-related quality of life (HRQOL) was achieved by individuals using the services under the LTCI system.
The subjects were inhabitants of two cities in the Kyushu district of Japan who were receiving daily home care services under the LTCI system. To analyze the relationships of the beneficiaries' HRQOL with their characteristics, the dependent variable was the EuroQol-5D (EQ-5D) scores adopted as an index of HRQOL, and the independent variables comprised the demographic features (gender, age, and living condition) of users receiving long-term care service as well as their opinions about fees for services, satisfaction with the services provided, and the degree of support/care required.
The EQ-5D score was higher for females than for males and higher for the subjects living alone than for those displaying any other family composition. EQ-5D score decreased with an increase in the degree of support/care required. Multivariate analysis revealed that the degree of support/care required, gender and living condition were found to serve as variables that significantly contribute to utility.
Our analysis of the relationships between the characteristics of the LTCI beneficiaries and their HRQOL has yielded basic data that will be useful for improving the recently introduced LTCI system.
日本于2000年引入了长期护理保险(LTCI)系统。明确该系统用户的信息以及服务的使用方式对于改善系统运行至关重要。本研究旨在明确使用LTCI系统服务的个人所达到的与健康相关的生活质量(HRQOL)水平。
研究对象为日本九州地区两个城市中接受LTCI系统日常居家护理服务的居民。为分析受益人的HRQOL与其特征之间的关系,因变量采用作为HRQOL指标的欧洲五维健康量表(EQ-5D)得分,自变量包括接受长期护理服务用户的人口统计学特征(性别、年龄和居住状况)以及他们对服务费用的看法、对所提供服务的满意度和所需支持/护理程度。
女性的EQ-5D得分高于男性,独居者的得分高于其他任何家庭构成的人群。EQ-5D得分随所需支持/护理程度的增加而降低。多变量分析显示,所需支持/护理程度、性别和居住状况是对效用有显著贡献的变量。
我们对LTCI受益人特征与其HRQOL之间关系的分析得出了基础数据,这些数据将有助于改进最近引入的LTCI系统。