Department of Health and Welfare Services, National Institute of Public Health, Saitama, Japan.
Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
PLoS One. 2018 Aug 29;13(8):e0203112. doi: 10.1371/journal.pone.0203112. eCollection 2018.
Home independence is an important issue for the elderly in many countries and cultures. The aim of this study was to examine the effect of short-stay service use on stay-at-home duration for elderly people by level of care need under the Japanese long-term care insurance system.
We analyzed anonymous, Ministry of Health, Labour and Welfare of Japan Long-Term Care Insurance claims data from Ibaraki Prefecture. All participants were certified as eligible for long-term care insurance and had moved into a facility under long-term care insurance after certification between April 2006 and March 2012. Data was analyzed for 2,454 participants aged 65 years or older who entered residential care at least 1 month after initial use of care services. The participants were divided into 2 groups (low- and high-care need), depending on their required level of care. Cox proportional hazard modeling was used to calculate the adjusted hazard ratio (HR) of residential care admission after initial use of care services.
Use of short-stay services was positively correlated to delay of residential care admission compared to non-use in the low-care need group (HR; 0.834, 95% confidence interval (CI); 0.740-0.939). In the high-care need group, however, use of short-stay services was somewhat correlated with earlier admission (HR; 1.254, 95% CI; 1.084-1.451).
The results of this study show that appropriate timing short-stay service use is necessary for the elderly to stay at home longer.
独立居家是许多国家和文化中老年人的重要问题。本研究旨在考察在日本长期护理保险制度下,根据护理需求水平,短期入住服务的使用对老年人居家时间的影响。
我们分析了来自茨城县的匿名、厚生劳动省日本长期护理保险索赔数据。所有参与者均符合长期护理保险资格,并在 2006 年 4 月至 2012 年 3 月期间通过认证后搬入长期护理保险设施。数据分析了 2454 名年龄在 65 岁及以上、在初始使用护理服务后至少 1 个月入住养老院的参与者。参与者根据所需护理水平分为低护理需求组和高护理需求组。使用 Cox 比例风险模型计算初始使用护理服务后入住养老院的调整风险比(HR)。
与不使用短期入住服务相比,低护理需求组使用短期入住服务与延迟入住养老院呈正相关(HR;0.834,95%置信区间(CI);0.740-0.939)。然而,在高护理需求组中,短期入住服务的使用与较早入住(HR;1.254,95% CI;1.084-1.451)有些相关。
本研究结果表明,老年人适当安排短期入住服务的使用对于延长其居家时间是必要的。