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The effects of dementia and long-term care services on the deterioration of care-needs levels of the elderly in Japan.

Lin HR, Otsubo T, Imanaka Y - Medicine (Baltimore) (2015)

Bottom Line: 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.The other risk factors of care-needs level deterioration showed stronger associations as care-needs levels and age increased.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan.

ABSTRACT
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.

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Related in: MedlinePlus

Subject selection. Flowchart detailing subject selection, the study sample for analysis comprised 50,268 subjects.
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Figure 1: Subject selection. Flowchart detailing subject selection, the study sample for analysis comprised 50,268 subjects.

Mentions: Subjects were excluded from analysis if they had fulfilled any of the following criteria: first, subjects classified as support levels 1 and 2 were excluded from analysis. Next, subjects who had not utilized LTC services in June 2011 and had been classified as care needs level 5 in June 2010 were also excluded, unless their death (deterioration) could be determined from the data. The deteriorating conditions could not be identified in care-needs level 5 unless the subjects were beneficiaries of National Healthcare Insurance, in which case we were able to identify if the patients had died. Furthermore, as diagnoses of dementia were identified using the relevant International Classification of Disease (ICD)-10 codes available in the National Healthcare Insurance Database and Old-Old Adults Medical Care Program Database (hereinafter, the 2 databases are collectively referred to as the “NHIDB”), service users who were not beneficiaries of National Healthcare Insurance were excluded from analysis. Also, people younger than 65 years were excluded. After employing these exclusion criteria, the study sample for analysis comprised 50,268 subjects, as shown in Figure 1.


The effects of dementia and long-term care services on the deterioration of care-needs levels of the elderly in Japan.

Lin HR, Otsubo T, Imanaka Y - Medicine (Baltimore) (2015)

Subject selection. Flowchart detailing subject selection, the study sample for analysis comprised 50,268 subjects.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554179&req=5

Figure 1: Subject selection. Flowchart detailing subject selection, the study sample for analysis comprised 50,268 subjects.
Mentions: Subjects were excluded from analysis if they had fulfilled any of the following criteria: first, subjects classified as support levels 1 and 2 were excluded from analysis. Next, subjects who had not utilized LTC services in June 2011 and had been classified as care needs level 5 in June 2010 were also excluded, unless their death (deterioration) could be determined from the data. The deteriorating conditions could not be identified in care-needs level 5 unless the subjects were beneficiaries of National Healthcare Insurance, in which case we were able to identify if the patients had died. Furthermore, as diagnoses of dementia were identified using the relevant International Classification of Disease (ICD)-10 codes available in the National Healthcare Insurance Database and Old-Old Adults Medical Care Program Database (hereinafter, the 2 databases are collectively referred to as the “NHIDB”), service users who were not beneficiaries of National Healthcare Insurance were excluded from analysis. Also, people younger than 65 years were excluded. After employing these exclusion criteria, the study sample for analysis comprised 50,268 subjects, as shown in Figure 1.

Bottom Line: 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.The other risk factors of care-needs level deterioration showed stronger associations as care-needs levels and age increased.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan.

ABSTRACT
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.

Show MeSH
Related in: MedlinePlus