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Shinohara H, Mikami Y, Kuroda R, Asaeda M, Kawasaki T, Kouda K, Nishimura Y, Ohkawa H, Uenishi H, Shimokawa T, Mikami Y, Tajima F, Kubo T. Rehabilitation in the long-term care insurance domain: a scoping review. HEALTH ECONOMICS REVIEW 2022; 12:59. [PMID: 36450881 PMCID: PMC9713971 DOI: 10.1186/s13561-022-00407-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE Since the enactment of the long-term care insurance (LTCI) act in 2000, the number of LTCI users has increased annually. However, evidence regarding what is being carried out as rehabilitation treatment under LTCI is lacking. In this study, a scoping review was performed to bridge this knowledge gap. METHODS Articles related to rehabilitation in connection with LTCI published between April 2000 and November 2020 were searched for in PubMed, CINAHL, CENTRAL (Cochrane Central Register of Controlled Trials), Ichushi Web Ver.5, and CiNii and randomized controlled trials (RCTs) of rehabilitation provided under LTCI were examined. RESULTS Of the 15,572 publications identified, 15 RCTs, including rehabilitation treatment by physiatrists and therapists, met the eligibility criteria of our review and were included. The rehabilitation trials in the 15 RCTs varied and included balance training, exercise therapy, cognitive tasks, and activities such as singing and dancing. The results allowed us to focus on three categories: fall prevention, dementia, and theory and tools interventions related to occupational therapy practice. CONCLUSION The focal points of attention in the rehabilitation treatment of LTCI were identified. However, the physical function, quality of life, and activities of daily living (ADL) of those who "need support" vary from person to person. Therefore, the consolidation of evidence on rehabilitation treatment of LTCI must be continued.
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Affiliation(s)
- Hiroshi Shinohara
- Graduate School of Health Science, Aomori University of Health and Welfare, 58-1 Mase, 030-8505, Hamadate, Aomori, Japan.
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, 734-8551, Hiroshima, Japan
| | - Rumi Kuroda
- School of Nursing, Fukushima Medical University, 1 Hikariga-oka, 960-1295, Fukushima, Japan
| | - Makoto Asaeda
- Department of Rehabilitation Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, 734-8551, Hiroshima, Japan
- Faculty of Wakayama Health Care Sciences, Takarazuka University of Medical and Health Care, 2252, 640-8392, Nakanoshima, Wakayama, Japan
| | - Takashi Kawasaki
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kawaramachi-Hirokoji, Kamigyo-ku, 602-8566, Kyoto, Japan
| | - Ken Kouda
- Department of Rehabilitation Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, 734-8551, Hiroshima, Japan
| | - Yukihide Nishimura
- Department of Rehabilitation Medicine, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Iwate, Japan
| | - Hiroyuki Ohkawa
- Department of Health and Nutrition Sciences, Faculty of Health and Nutrition Sciences, Nishikyushu University, 4490-9 Osaki, Kanzaki-machi, 842-8585, Kanzaki, Saga, Japan
| | - Hiroyasu Uenishi
- Faculty of Wakayama Health Care Sciences, Takarazuka University of Medical and Health Care, 2252, 640-8392, Nakanoshima, Wakayama, Japan
| | - Toshio Shimokawa
- Clinical Study Support Center, Wakayama Medical University, 811-1 Kimiidera, 641-8509, Wakayama, Japan
| | - Yasuo Mikami
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kawaramachi-Hirokoji, Kamigyo-ku, 602-8566, Kyoto, Japan
| | - Fumihiro Tajima
- Department of Rehabilitation Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, 734-8551, Hiroshima, Japan
| | - Toshikazu Kubo
- Department of Orthopedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kawaramachi-Hirokoji, Kamigyo-ku, 602-8566, Kyoto, Japan
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Viggars RJ, Finney A, Panayiotou B. Educational programmes for frail older people, their families, carers and healthcare professionals : A systematic review. Wien Klin Wochenschr 2021; 134:227-236. [PMID: 34196803 PMCID: PMC8245918 DOI: 10.1007/s00508-021-01900-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 05/23/2021] [Indexed: 11/24/2022]
Abstract
Background More people are living with frailty and requiring additional health and support services. To improve their management, the “Frailty: Core Capability Framework” in the United Kingdom recommends frailty education for older individuals, their families, carers and health professionals. We performed a systematic review of specific educational programmes for these groups. Methods Electronic databases were searched using dedicated search terms and inclusion criteria. To improve accuracy, two reviewers carried out the screening and selection of research papers. Information from included studies was collected using a tailored data extraction template, and quality appraisal tools were used to assess the rigour of the studies. The findings were analysed to identify key themes. Results A total of 11 studies met the criteria and were included in the review. The study populations ranged from 12 to 603 and the research designs were heterogeneous (6 qualitative; 2 randomised controlled trials; 1 quasi-experimental; 1 mixed methods; 1 cross-sectional study). Whilst some methodological shortcomings were identified, all studies contributed valuable information. The results underwent narrative synthesis, which elucidated four thematic domains: (1) accessibility of educational programmes, (2) empowerment, (3) self-care, and (4) health promotion (especially exercise and nutrition). Conclusion Educational programmes for older people, their carers and health professionals are important for effective frailty prevention and management. To be maximally beneficial, they should be easily accessible to all target populations and include empowerment, self-care and health promotion. Further research should explore the formulation of widely applicable, user-friendly programmes and delivery formats that can be tailored to different client groups.
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Affiliation(s)
- Rachel J Viggars
- North Staffordshire General Practice Federation, 69-71 Stafford Street, ST1 1LS, Hanley, UK.
| | - Andrew Finney
- School of Nursing & Midwifery, Keele University, Stoke-on-Trent, ST5 5BG, Staffordshire, UK
| | - Barnabas Panayiotou
- Postgraduate School of Medicine, Keele University, Stoke-on-Trent, ST5 5BG, Staffordshire, UK
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Wong ZSY, Hoshino E, Ikegami N. A Cost Projection of Scheduled Physician Home-Visit Services in Japan: 2014 to 2064. J Aging Soc Policy 2020; 33:692-707. [PMID: 32552575 DOI: 10.1080/08959420.2020.1777835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study predicts the volume and spending on scheduled physician home-visit (SPHV) services over five decades. This model-based evaluation study considered the following scenarios in Japan: (1) change in services-delivery; (2) technology-assisted services; (3) a combination of (1) and (2). The model predicted that the volume and spending on SPHV will increase as the population and working-age population decline. Scenario analysis indicated that a combined strategy could reduce the relative rate of spending to less than 2.00 in 2064, indicating that home health-care service reforms through changes in services-delivery and cost-reduction through technology-assisted services are promising in countries facing aging population.
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Affiliation(s)
- Zoie Shui-Yee Wong
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Eri Hoshino
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Naoki Ikegami
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
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Supplied Food Consistency and Oral Functions of Institutionalized Elderly. Int J Dent 2020; 2020:3463056. [PMID: 32148501 PMCID: PMC7031709 DOI: 10.1155/2020/3463056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/14/2020] [Accepted: 01/21/2020] [Indexed: 12/04/2022] Open
Abstract
Background Maintaining good oral function is one of the goals of dental treatment. The Japanese national insurance system newly introduced the concept of management of oral function according to the life stage. For the application of management of oral functions of the elderly, seven kinds of examination is a must for the diagnosis: xerostomia, oral hygiene status, maximum occlusal pressure, tongue and labium function, tongue pressure, chewing ability, and swallowing function. We analyzed the relationship between oral functions and supplied food consistency. Methods Oral functions and supplied food consistency of sixty-nine institutionalized elderly were investigated. There were 13 men and 56 women, and their mean age was 86.23 ± 7.02. Oral functions were measured and evaluated according to the Japanese insurance system. Data were analyzed by item response theory analysis, ROC analysis, and decision analysis. Results By the item response theory analysis, tongue pressure and swallowing functions had high discrimination ability. The subjects who had malfunction of the tongue and labium all had processed food. The subjects with difficulty in swallowing, even without malfunction of the tongue and labium, all had processed food. Conclusion Supplied food consistency may depend on the oral functions. However, as oral function has some dimension, a systematic evaluation system is necessary to decide the supplied food consistency.
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Salahudeen MS, Nishtala PS. A Systematic Review Evaluating the Use of the interRAI Home Care Instrument in Research for Older People. Clin Gerontol 2019. [PMID: 29543580 DOI: 10.1080/07317115.2018.1447525] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective: To summarize studies that used the international Resident Assessment home care instrument (interRAI HC) to examine study outcomes for older people. Methods: A comprehensive systematic search was performed to identify relevant studies, using five databases from 1990 until October 2016. The Cochrane Risk-Bias assessment tool and Newcastle-Ottawa Scale was used to assess the quality of RCTs and non-RCTs, respectively. Results: Based on the full-text analysis, 40 studies met the inclusion criteria out of 506 total records. The review included 6 RCTs, 2 quasi-experimental, 17 prospective and retrospective studies, 13 cross-sectional and 2 longitudinal studies. A series of interventions and/or applications were identified from this review that employed the use of interRAI HC instrument: (a) in health services, (b) as a new integrated care model and for implementing machine learning algorithm, (c) as a comprehensive geriatric assessment tool, (d) in case management, (e) for care planning and screening, (f) in drug therapy assessment, (g) to assess caregiver burden, and (h) for various risk assessments. Studies that employed the interRAI HC instrument reported an array of health-outcome measures mostly related to functional, cognition, hospitalization and mortality. Conclusions: Application of the interRAI HC tool varied markedly across all studies, and the outcomes measures were heterogeneous. Future research directions are discussed. Clinical Implications: The results from this study facilitate the use of interRAI HC as a tool to measure an intervention's effect that leads to improvements in specific geriatric-related health outcome measures emphasizes on functional status and quality of life and ascertain its utility as a quality indicator for the care of older individuals.
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Nomura Y, Okada A, Kakuta E, Otsuka R, Sogabe K, Yamane K, Yamamoto T, Shigeta Y, Shigemoto S, Ogawa T, Hanada N. Consistency of supplied food and dentition status of the elderly in residential care homes. BMC Oral Health 2019; 19:74. [PMID: 31046753 PMCID: PMC6498674 DOI: 10.1186/s12903-019-0770-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 04/23/2019] [Indexed: 02/06/2023] Open
Abstract
Background The association between oral health and malnutrition has been investigated in detail. The nutrition of elderly subjects in residential care homes is determined by caregivers, dietitians or nutritionists and managed by changing the consistency of their supplied food. However, few reports have described the relationship between oral condition and supplied food consistency. The objective of this study was to determine dentition status and care levels that correlate with supplied food consistency among elderly residents of care facilities. In addition, we estimated the care level at which ordinary food consistency can be supplied by caregivers who cannot diagnose dental status. Method Several factors, including dentition, wearing removable dentures, meals categorized as ordinary or processed (sliced, mashed, or liquefied), and care levels according to the Japanese standardized care-needs certification system were investigated in 276 elderly residents (male, n = 56; female, n = 220; mean age, 87.68 ± 5.94 years) of 12 fee-based care facilities. Results The results of this study showed that care levels were significantly correlated with the consistency of the food supplied to the residents. When supplied food consistency was categorized as ordinary or processed, the number of remaining teeth and the number of tooth contact pairs, either natural or artificial, were statistically significant. From logistic regression analysis, it was determined that the numbers of tooth contact pairs were statistically significant among residents requiring high levels of care. Conclusion The number of tooth contact pairs, either natural or artificial, was one of the contributing factors for deciding supplied food consistency among elderly residents of care facilities. Elderly residents requiring less than care level 3 should have ordinary meals. Electronic supplementary material The online version of this article (10.1186/s12903-019-0770-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yoshiaki Nomura
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan.
| | - Ayako Okada
- Department of Operative Dentistry, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Erika Kakuta
- Department of Oral Microbiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Ryoko Otsuka
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Kaoru Sogabe
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Kiyoshige Yamane
- Yamane Dental Clinic KUNSHIKAI Medical Corporation, 7-9, Tennojiya, Yao-shi, Osaka, 581-0025, Japan
| | - Taku Yamamoto
- Supercourt Co, Ltd, 1-7-7, Nishihommachi, Nishi-ku Osaka-shi, Osaka, 550-0005, Japan
| | - Yuko Shigeta
- Department of Fixed Prosthodontics, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Shuji Shigemoto
- Department of Fixed Prosthodontics, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Takumi Ogawa
- Department of Fixed Prosthodontics, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Nobuhiro Hanada
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
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Davis J, Morgans A, Burgess S. Information management in the Australian aged care setting. HEALTH INF MANAG J 2016; 46:3-14. [DOI: 10.1177/1833358316639434] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Information management systems and processes have an impact on quality and safety of care in any setting and particularly in the complex care setting of aged care. Few studies have comprehensively examined information management in the Australian aged care setting. Objective: To (i) critically analyse and synthesize evidence related to information management in aged care, (ii) identify aged care data collection frameworks and (iii) identify factors impacting information management. Methods: An integrative review of Australian literature published between March 2008 and August 2014 and data collection frameworks concerning information management in aged care were carried out. Results: There is limited research investigating the information-rich setting of aged care in Australia. Electronic systems featured strongly in the review. Existing research focuses on residential settings with community aged care largely absent. Information systems and processes in the setting of aged care in Australia are underdeveloped and poorly integrated. Conclusions: Data quality and access are more problematic within community aged care than residential care settings. The results of this review represent an argument for a national approach to information management in aged care to address multiple stakeholder information needs and more effectively support client care.
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Affiliation(s)
- Jenny Davis
- Benetas, Victoria, Australia
- Monash University, Australia
| | - Amee Morgans
- Monash University, Australia
- Royal District Nursing Service, Victoria, Australia
| | - Stephen Burgess
- Benetas, Victoria, Australia
- Monash University, Australia
- Royal District Nursing Service, Victoria, Australia
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De Almeida Mello J, Hermans K, Van Audenhove C, Macq J, Declercq A. Evaluations of Home Care Interventions for Frail Older Persons Using the interRAI Home Care Instrument: A Systematic Review of the Literature. J Am Med Dir Assoc 2015; 16:173.e1-10. [DOI: 10.1016/j.jamda.2014.11.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/06/2014] [Accepted: 11/07/2014] [Indexed: 11/25/2022]
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Olivares-Tirado P, Tamiya N, Kashiwagi M. Effect of in-home and community-based services on the functional status of elderly in the long-term care insurance system in Japan. BMC Health Serv Res 2012; 12:239. [PMID: 22863362 PMCID: PMC3505459 DOI: 10.1186/1472-6963-12-239] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 07/19/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Japan is setting the pace among aging societies of the world. In 2005, Japan became the country with the highest proportion of elderly persons in the world. To deal with the accelerated ageing population and with an increased demand for long-term care services, in April 2000 the Japanese government introduced a mandatory social Long-Term Care Insurance System (LTCI), making long-term care services a universal entitlement for elderly. Overseas literature suggests that the effectiveness of a home visiting program is uncertain in terms of preventing a decline in the functional status of elderly individuals. In Japan, many studies regarding factors associated with LTC service utilization have been conducted, however, limited evidence about the effect of LTC services on the progression of recipient disability is available. METHODS Data were obtained from databases of the LTC insurer of City A. To examine the effect of in-home and community-based services on disability status of recipients, a survival analysis in a cohort of moderately disabled elderly people, was conducted. RESULTS The mean age of participants was 81 years old, and females represented 69% of the participants. A decline or an improvement in functional status, was observed in 43% and 27% of the sample, respectively. After controlling for other variables, women had a significantly greater probability of improving their functional status during all phases of the observation period. The use of "one service" and the amount of services utilized (days/month), were marginally (p = < 0.10) associated with a greater probability of improving their functional status at 12 months into the observation period. CONCLUSIONS The observed effects of in-home and community-based services on disability transition status were considered fairly modest and weak, in terms of their ability to improve or to prevent a decline in functional status. We suggest two mechanisms to explain these findings. First, disability transition as a measure of disability progression may not be specific enough to assess changes in functional status of LTCI recipients. Secondly, in-home and community-based services provided in City A, may be inappropriate in terms of intensity, duration or quality of care.
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Affiliation(s)
- Pedro Olivares-Tirado
- Department of Health Services Research, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tenno-dai Tsukuba, Ibaraki 305-8575, Japan
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Tomita N, Yoshimura K, Ikegami N. Impact of home and community-based services on hospitalisation and institutionalisation among individuals eligible for long-term care insurance in Japan. BMC Health Serv Res 2010; 10:345. [PMID: 21176165 PMCID: PMC3024297 DOI: 10.1186/1472-6963-10-345] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Accepted: 12/22/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This population-based retrospective cohort study aimed to clarify the impact of home and community-based services on the hospitalisation and institutionalisation of individuals certified as eligible for long-term care insurance (LTCI) benefits. METHODS Health insurance data and LTCI data were combined into a database of 1,020 individuals in two farming communities in Hokkaido who were enrolled in Citizen's Health Insurance. They had not received long-term care services prior to April 1, 2000 and were newly certified as eligible for Long-Term Care Insurance benefits between April 1, 2000 and February 29, 2008. The analysis covered 565 subjects who had not been hospitalised or institutionalised at the time of first certification of LTCI benefits. The adjusted hazard ratios (HRs) of hospitalisation or institutionalisation or death after the initial certification were calculated using the Cox proportional hazard model. The predictors were age, sex, eligibility level, area of residence, income, year of initial certification and average monthly outpatient medical expenditures, in addition to average monthly total home and community-based services expenditures (analysis 1), the use or no use of each type of service (analysis 2), and average monthly expenditures for home-visit and day-care types of services, the use or no use of respite care, and the use or no use of rental services for assistive devices (analysis 3). RESULTS Users of home and community-based services were less likely than non-users to be hospitalised or institutionalised. Among the types of services, users of respite care (HR: 0.71, 95% confidence interval [CI]: 0.55-0.93) and rental services for assistive devices (HR: 0.70, 95% CI: 0.54-0.92) were less likely to be hospitalised or institutionalised than non-users. For those with relatively light needs, users of day care were also less likely to be hospitalised or institutionalized than non-users (HR: 0.77, 95% CI: 0.61-0.98). CONCLUSIONS Respite care, rental services for assistive devices and day care are effective in preventing hospitalisation and institutionalisation. Our results suggest that home and community-based services contribute to the goal of the LTCI system of encouraging individuals certified as needing long-term care to live independently at home for as long as possible.
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Affiliation(s)
- Naoki Tomita
- Department of Health Policy & Management, Keio University School of Medicine, Tokyo, Japan
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