Lin Huei-Ru, Otsubo Tetsuya, Imanaka Yuichi
From the Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan.
Medicine (Baltimore). 2015 Feb;94(7):e525. doi: 10.1097/MD.0000000000000525.
To investigate the associations between dementia, the use of long-term care (LTC) services, and the deterioration of care-needs levels of elderly persons in Japan. Using a retrospective cohort study, we analyzed 50,268 insurance beneficiaries aged 65 years and older who had utilized LTC services between 2010 and 2011 in Kyoto prefecture, Japan. Logistic regression analyses were used to identify predictors of care-needs level deterioration. Dementia, facility care services, the male sex, older age, and lower baseline care-needs levels were associated with care-needs level deterioration. The disparity between odds ratios of home care services, dementia diagnoses, and facility care services on care-needs level deterioration diminished with increasing baseline care-needs levels. The other risk factors of care-needs level deterioration showed stronger associations as care-needs levels and age increased. The effects of baseline care-needs levels and dementia should be considered when developing LTC policies.
为了调查日本痴呆症、长期护理（LTC）服务的使用与老年人护理需求水平恶化之间的关联。我们采用回顾性队列研究，分析了2010年至2011年期间在日本京都府使用LTC服务的50268名65岁及以上的保险受益人。采用逻辑回归分析来确定护理需求水平恶化的预测因素。痴呆症、机构护理服务、男性、高龄以及较低的基线护理需求水平与护理需求水平恶化相关。随着基线护理需求水平的提高，家庭护理服务、痴呆症诊断和机构护理服务对护理需求水平恶化的优势比之间的差距减小。随着护理需求水平和年龄的增加，护理需求水平恶化的其他风险因素显示出更强的关联。在制定长期护理政策时，应考虑基线护理需求水平和痴呆症的影响。
