Factors associated with the use of home-visit nursing services covered by the long-term care insurance in rural Japan: a cross-sectional study

BMC Geriatrics

Eiji Yano²  Mikiya Sato¹  Nanako Tamiya¹  Masayo Kashiwagi¹ 

[1] Department of Health Services Research, faculty of medicine, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba Ibaraki, 305-8575, Japan;Department of Hygiene and Public Health, Teikyo University, School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 174-8605, Japan

关键词: Home-help service;    Income level;    Living alone;    Care-needs level;    Community-based service;    Care management;    Long-term care insurance;    Home-visit nursing service;   

Others  :  857954
DOI  :  10.1186/1471-2318-13-1

 received in 2012-01-14, accepted in 2012-12-18,  发布年份 2013

【 摘 要 】

Background

In Japan, there is a large increase in the number of elderly persons who potentially need home-visit nursing services (VNS). However, the number of persons using the VNS has increased only little in comparison to the number of individuals who use home social services, which are also covered by the Long-Term Care Insurance (LTCI) system. This cross-sectional study investigated the predictors of the VNS used under the LTCI system in Japan.

Methods

We used 1,580 claim data from all the users of community-based services and 1,574 interview survey data collected in 2001 from the six municipal bodies in Japan. After we merged the two datasets, 1,276 users of community-based services under the LTCI were analyzed. Multiple logistic regression models stratified by care needs levels were used for analysis.

Results

Only 8.3% of the study subjects were VNS users. Even among study participants within the higher care-needs level, only 22.0% were VNS users. In the lower care level group, people with a higher care level (OR: 3.50, 95% CI: 1.50–8.93), those whose condition needed long term care due to respiratory or heart disease (OR: 4.31, 95% CI: 1.88–89.20), those whose period of needing care was two years or more (OR: 2.01, 95% CI: 1.14–3.48), those whose service plan was created by a medical care management agency (OR: 2.39, 95% CI: 1.31–4.33), those living with family (OR: 1.86, 95% CI: 1.00–3.42), and those who use home-help services (OR: 2.12, 95% CI: 1.17–3.83) were more likely to use the VNS. In the higher care level group, individuals with higher care level (OR: 3.63, 95% CI: 1.56–8.66), those with higher income (OR: 3.79, 95% CI: 1.01–14.25), and those who had regular hospital visits before entering the LTCI (OR: 2.36, 95% CI: 1.11–5.38) were more likely to use the VNS.

Conclusions

Our results suggested that VNS use is limited due to management by non-medical care management agencies, due to no caregivers being around or a low income household. The findings of this study provide valuable insight for LTCI policy makers: the present provision of VNS should be reconsidered.

【 授权许可】

   
2013 Kashiwagi et al.; licensee BioMed Central Ltd.

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