Factors associated with the use of home-visit nursing services covered by the long-term care insurance in rural Japan: a cross-sectional study.
Factors associated with the use of home-visit nursing services covered by the long-term care insurance in rural Japan: a cross-sectional study.
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DOI：
10.1186/1471-2318-13-1
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发表时间：
2013-01-02
期刊：
影响因子：
4.1
通讯作者：
Yano E
中科院分区：
文献类型：
--
作者：
Kashiwagi M;Tamiya N;Sato M;Yano E
在日本，有可能需要上门护理服务（VNS）的老年人数量大幅增加。然而，与使用家庭社会服务的人数相比，使用自愿住院服务的人数增加很少，家庭社会服务也由长期护理保险制度覆盖。这项横断面研究调查了日本LTCI系统下使用的VNS的预测因素。我们使用了2001年从日本六个市町村团体收集的1，574份访谈调查数据和所有社区服务用户的1，580份索赔数据。在我们合并两个数据集后，我们分析了LTCI下的1，276名社区服务用户。采用按护理需求水平分层的多元逻辑回归模型进行分析。只有8.3%的研究对象是VNS用户。即使在较高护理需求水平的研究参与者中，也只有22.0%的人是VNS用户。在较低护理水平组中，护理水平较高的人（OR：3.50，95%CI：1.50-8.93），因呼吸系统或心脏疾病需要长期护理者（OR：4.31，95%CI：1.88-89.20），需要护理时间≥ 2年者（OR：2.01，95%CI：1.14-3.48），服务计划由医疗管理机构制定者（OR：2.39，95%CI：1.31-4.33）、与家人同住者（OR：1.86，95%CI：1.00-3.42）和使用家庭服务者（OR：2.12，95%CI：1.17-3.83）更可能使用VNS。在高护理水平组中，高护理水平（OR：3.63，95%CI：1.56-8.66）、高收入（OR：3.79，95%CI：1.01-14.25）和在进入LTCI前定期住院的人（OR：2.36，95%CI：1.11-5.38）更有可能使用VNS。我们的研究结果表明，VNS的使用是有限的，由于非医疗管理机构的管理，由于没有照顾者周围或低收入家庭。本研究的结果提供了宝贵的见解LTCI政策制定者：目前提供的VNS应重新考虑。
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. 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. 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. 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.
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影响因子：
4.1
作者：
Kato G;Tamiya N;Kashiwagi M;Sato M;Takahashi H
通讯作者：
Takahashi H
影响因子：
120.7
作者：
Ikegami, N
通讯作者：
Ikegami, N
DOI：
10.1111/j.1532-5415.1993.tb06762.x
发表时间：
1993-09-01
影响因子：
6.3
作者：
SOLOMON, DH;WAGNER, DR;INOUYE, SK
通讯作者：
INOUYE, SK
DOI：
10.2307/3349613
发表时间：
1973-01-01
期刊：
MILBANK MEMORIAL FUND QUARTERLY-HEALTH AND SOCIETY
影响因子：
--
作者：
ANDERSEN, R;NEWMAN, JF
通讯作者：
NEWMAN, JF
DOI：
10.1093/geronj/49.1.s25
发表时间：
1994-01-01
期刊：
JOURNALS OF GERONTOLOGY
影响因子：
--
作者：
LOGAN, JR;SPITZE, G
通讯作者：
SPITZE, G