Ida O, Tatara K, Fujiwara H, Takashima Y, Kuroda K
Department of Public Health, Osaka University Medical School, Japan.
Soc Sci Med. 1996 Dec;43(11):1527-32. doi: 10.1016/s0277-9536(96)00047-0.
Japan's population is aging rapidly. As in other developed countries, the establishment of a system of care for the elderly, especially for those suffering from dementia, has become an urgent issue. As the role of welfare offices, which is to directly serve the people, has become increasingly important, the need to assess their use in terms of demographic factors has risen. With respect to demographic factors, this study analyses the use of the welfare services by the demented elderly at city welfare offices in Japan from 1987 to 1989. In December 1991, questionnaires were mailed to 670 city welfare offices nationwide, excluding those located in designated large cities and special wards in Tokyo. Four-hundred and thirty-seven (65.2%) of the offices responded. Offices located in areas with a relatively high percentage of elderly reported giving fewer counselling sessions and reported fewer people registered for or utilizing domiciliary welfare services than offices in areas with a relatively low percentage of elderly. The differences between the two areas in the total amount of counselling, counselling cases at the welfare office, and respite-care for 1989 and day-care service registration were significant. The Pearson's correlation coefficients for the percentage of elderly and these activities all showed negative values, except for home-help utilization in 1987 and 1989. Welfare offices in which the number of activities increased significantly over the 3 years examined in this study were more common in the areas where a committee for communication between medical and welfare sectors (hereinafter "liaison-committee") existed. Discriminant analysis suggests a correlation between the existence of a liaison-committee and the following variables: the percentage of the elderly living alone, the number of home-helpers per elderly, the capacity of day-care service per elderly and the number of surgeries per elderly. From the results, it is apparent that the welfare offices in areas with a high elderly percentage tended to have less activity. Today, municipalities with a high percentage of elderly in its population are particularly required to draw up plans for their health and welfare. The establishment of a network like a liaison-committee will enable the municipalities to achieve their goals.
日本人口正在迅速老龄化。与其他发达国家一样，建立老年人护理体系，尤其是针对痴呆症患者的护理体系，已成为一个紧迫问题。随着直接服务民众的福利办公室的作用日益重要，根据人口因素评估其使用情况的需求也随之增加。关于人口因素，本研究分析了1987年至1989年日本城市福利办公室中痴呆老年人对福利服务的使用情况。1991年12月，向全国670个城市福利办公室邮寄了调查问卷，不包括位于东京指定大城市和特别区的办公室。其中437个办公室（65.2%）做出了回应。与老年人比例相对较低地区的办公室相比，老年人比例相对较高地区的办公室报告的咨询次数较少，登记或使用居家福利服务的人数也较少。这两个地区在1989年的咨询总量、福利办公室的咨询案例、临时护理以及日托服务登记方面的差异具有显著性。除了1987年和1989年的居家帮助使用情况外，老年人比例与这些活动的皮尔逊相关系数均显示为负值。在本研究考察的3年中活动数量显著增加的福利办公室，在设有医疗与福利部门沟通委员会（以下简称“联络委员会”）的地区更为常见。判别分析表明联络委员会的存在与以下变量之间存在相关性：独居老年人的比例、每位老年人的居家帮助人员数量、每位老年人的日托服务容量以及每位老年人的手术次数。从结果来看，显然老年人比例高的地区的福利办公室活动较少。如今，老年人口比例高的市尤其需要制定其健康和福利计划。建立像联络委员会这样的网络将使各市能够实现其目标。
