Relationship between home care service use and changes in the care needs level of Japanese elderly.
Relationship between home care service use and changes in the care needs level of Japanese elderly.
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DOI：
10.1186/1471-2318-9-58
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发表时间：
2009-12-21
期刊：
影响因子：
4.1
通讯作者：
Takahashi H
中科院分区：
文献类型：
--
作者：
Kato G;Tamiya N;Kashiwagi M;Sato M;Takahashi H
随着日本引入长期护理保险（LTCI），社区老年人可以获得更多的家庭护理服务。为了提供有效的家庭护理服务，了解服务使用的效果非常重要。在本研究中，作为确定这一点的第一步，我们试图描述护理需求水平持续/改善组和恶化组的不同家庭服务使用情况，并报告家庭护理服务的使用与护理需求水平变化之间的关系。日本某城市共有 1,474 名 LTCI 服务用户，其中 624 名是参与者。根据基线护理需求水平，家庭护理服务用户被分为“较低护理需求水平亚组”和“较高护理需求水平亚组”。进行了简单的统计比较和多重逻辑回归分析，其中护理需求水平的变化被设置为因变量。性别、年龄和基线护理需求水平被指定为控制变量。家庭服务被视为自变量。在这项研究中，家庭护理服务包括家庭帮助、家庭沐浴服务、上门护士、家庭康复、疗养院日托、健康日托、医疗器械借用、疗养院暂托住宿、医疗机构暂托住宿、疗养院型医疗机构暂托住宿以及医生的医疗管理。在较低护理需求水平亚组中，年龄（OR = 1.04，CI，1.01-1.08）、在疗养院暂住的情况（OR = 2.55；CI，1.43-4.56）以及 11 个月期间使用的长期护理服务类型数量（OR = 1.33；CI，1.02-1.74）与护理需求恶化显着相关。用户的护理需求水平。在较高护理需求水平亚组中，医生使用医疗管理（OR = 6.99；CI，1.42-41.25）与用户护理需求水平的恶化显着相关。没有与维持或改善用户的护理需求水平显着相关的家庭服务。两组（持续/改善组和恶化组）的家庭服务使用情况不同。在日本，护理需求水平较低的社区居住老年人的护理需求水平恶化与疗养院服务使用的暂托停留和更多类型的服务使用有关。此外，医生服务的医疗管理与护理需求水平较高的社区居住老年人的护理需求水平恶化有关。
With the introduction of long-term care insurance (LTCI) in Japan, more home care services are available for the community-dwelling elderly. To deliver effective home care services, it is important to know the effects of service use. In this study, as the first step to determine this, we sought to describe different home service use in the sustained/improved group and deteriorated group in their care needs levels, and to report the relationship between the use of home care services and changes in care needs levels. The participants included 624 of a total of 1,474 users of LTCI services in one city in Japan. Home care service users were stratified into a 'lower care needs level subgroup' and a 'higher care needs level subgroup' based on the baseline care needs level. Simple statistical comparison and multiple logistic regression analyses in which the change in care needs level was set as a dependent variable were performed. Gender, age, and baseline care needs level were designated as control variables. Home based services were treated as independent variables. In this study, home care services consisted of home help, home bathing services, a visiting nurse, home rehabilitation, nursing home daycare, health daycare, loan of medical devices, respite stay in a nursing home, respite stay in a health care facility, respite stay in a sanatorium-type medical care facility, and medical management by a physician. In the lower care needs level subgroup, age (OR = 1.04, CI, 1.01-1.08), use of respite stay in a nursing home (OR = 2.55; CI, 1.43-4.56), and the number of types of long-term care services (OR = 1.33; CI, 1.02-1.74) used during an 11 month period were significantly related to a deterioration of the user's care needs level. In the higher care needs level subgroup, use of medical management by a physician (OR = 6.99; CI, 1.42-41.25) was significantly related to a deterioration of the user's care needs level. There were no home based services significantly related to sustaining or improving the user's care needs level. There were different home service use in two groups (the sustained/improved group and the deteriorated group). Respite stay in a nursing home service use and more types of service use were related to experiencing a deterioration of care needs level in lower care needs level community-dwelling elderly persons in Japan. Further, medical management by a physician service was related to experiencing a deterioration of care needs level in higher care needs level community-dwelling elderly persons.