Patterns of long-term care service use and multimorbidity in older Japanese adults: A cross-sectional study of claim data.

Autor: Sagawa M; Department of Home Health and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Noguchi-Watanabe M; Department of Home Health and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Fukui S; Department of Home Health and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Geriatrics & gerontology international [Geriatr Gerontol Int] 2024 Mar; Vol. 24 (3), pp. 283-289. Date of Electronic Publication: 2024 Jan 23.
DOI: 10.1111/ggi.14812
Abstrakt: Aim: The long-term care (LTC) insurance system provides a combination of several services in Japan; therefore, it is important to clarify service utilization. Furthermore, it is important to consider multimorbidity among older adults, who frequently present several diseases. This study aimed to clarify LTC service utilization patterns, including those for newly added multifunctional services, and to describe the basic characteristics, including multimorbidity, of these patterns.
Methods: We included 37 419 older adults in care need levels 1-5, living at home, who used LTC services in October 2017. We used LTC and medical claims data that were linked using unique identifiers from the National Health Insurance, Advanced Elderly Medical Insurance, and LTC Insurance of Shizuoka Prefecture in Japan. LTC service utilization patterns were identified using cluster analysis based on service fees. Multimorbidity was analyzed using the Charlson Comorbidity Index (CCI) and compared characteristics in these patterns.
Results: Six LTC service utilization patterns were identified: light use (51.0%), intensive use of day care (33.7%), intensive use of short stay (6.3%), intensive use of home help (5.1%), multifunctional LTC in small-group homes (MLS) use (3.7%), and MLS and home-visiting nurses (MLSH) use (0.2%). MLSH use had the highest CCI (3.6 ± 2.3). Intensive use of day care and short stay had the lowest CCI (2.6 ± 1.9).
Conclusions: The characteristics of multimorbidity differed by LTC service utilization patterns. Our findings are useful for considering service utilization that takes into account the characteristics of older adults. Geriatr Gerontol Int 2024; 24: 283-289.
(© 2024 Japan Geriatrics Society.)
Databáze: MEDLINE
Externí odkaz: