The Effect of Utilization of In-home Services and the Changes in Levels of Care Needs of Frail Persons (2002-2004): Results of a Two-year Follow-up Study.
The Effect of Utilization of In-home Services and the Changes in Levels of Care Needs of Frail Persons (2002-2004): Results of a Two-year Follow-up Study.
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DOI：
10.2185/jrm.7.6
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发表时间：
2012-01-01
期刊：
影响因子：
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通讯作者：
Shiwaku, Kuninori
中科院分区：
文献类型：
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作者：
Kim, Jung-Nim;Shiwaku, Kuninori
目的：尽管越来越多地利用家庭服务，对那些有认证的护理需求水平的家庭服务的评估一直局限于个人结果的实际变化。本研究的目的是确定影响因素如何利用家庭服务可以持续和/或改善或恶化的护理需求水平的体弱者。我们还研究了在家庭服务中使用的低水平的护理需求子组和高水平的护理需求子组在一个为期两年的periods.SUBJECTS和METHODS：我们使用的纵向数据从出云市的那些个人认证的护理需求水平的变化，在出云市的护理需求水平在2002年至2004年。2002年，有2 651人经证明有护理需要。排除了2002年护理需求为5级的护理设施的所有永久居民、2002年以来死亡的人以及在两年随访期间无法找到的人。最终分析了1，788名体弱者的剩余数据。我们将护理需求水平的变化随意分为两类：持续/改善和恶化。在基线时，护理需求水平也被分层为较低水平的护理需求亚组和较高水平的护理需求亚组。简单的统计分析和二元逻辑回归分析被认为是相关的因素，在家庭服务利用数据预测的变化需要levels.Results：约63.3%的受访者有一个持续或改善的护理需求水平，36.7%的受访者表示恶化的护理需求水平。在较低水平的护理需求亚组中，利用家庭帮助/洗澡（OR=2.59）与显著的持续/改善的护理需求水平相关。在较高层次的护理需求亚组中，（OR=0.90）和短期服务（OR=0.87）分别与恶化的护理需求水平显著相关。这项研究表明，在较低水平的护理需求亚组中，家庭帮助/洗澡护理是持续/在2006年，委员会注意到，在护理需求较高的分组中，短期护理服务和日间护理服务对护理需求的持续/改善有负面影响。我们的研究结果表明，利用家庭帮助服务可以防止这些水平的护理需求在体弱者的恶化。
OBJECTIVES: Despite the increasing utilization of in-home services, the assessment of in-home services used by those that have certified levels of care needs has been limited to the actual changes in individual outcomes. The purpose of the present study was to determine factors affecting how the utilization of in-home services could have sustained and/or improved or deteriorated the care needs levels of frail persons. We also examined the effect of in-home services used in the lower level of care needs subgroup and the higher level of care needs subgroup during a two-year period.SUBJECTS AND METHODS: We used longitudinal data from Izumo City of those individuals with certified levels of care needs to analyze the changes in care need levels in Izumo City between 2002 to 2004. In 2002, 2,651 persons had certified levels of care needs. All permanent residents of care facilities, at care needs level 5 in 2002, those who died since 2002 and people who could not be traced during the two-year follow-up period were excluded. The remaining data from 1,788 frail persons were ultimately analyzed. We arbitrarily divided the changes in care needs levels into two categories: sustained/improved and deteriorated. The care needs levels were also stratified into a lower level of care needs subgroup and a higher level of care needs subgroup at the baseline. Simple statistical analysis and binary logistic regression analysis were used to analyze factors that were thought to be related to in-home service utilization data to predict changes in care needs levels.RESULTS: Approximately 63.3% of the respondents had a sustained or improved care needs level, and 36.7% of the respondents showed deteriorated of care needs levels. In the lower level of care needs subgroup, utilization of home help/bathing (OR=2.59) was associated with significant sustained/improved care needs levels. In the higher level of care needs subgroup, day care service (OR=0.90) and short stay services (OR=0.87) were significantly related to deteriorated care needs levels, respectively.CONCLUSIONS: This study shows that home help/bathing care in the lower level of care needs subgroup was a significant predictor of sustained/improved levels of care needs for frail persons but that short stay services and day care services in the higher level of care needs subgroup have a negative impact on sustained/improved levels of care needs. Our results suggest that utilization of home help services can prevent deterioration of these levels of care needs in frail persons.