Comparative study for the degree of meeting health and social service needs of the frail elderly between before and after implementing Japanese long term care insurance

本研究的目的是比较日本实施长期护理保险前后，体弱老人的健康和社会服务需求得到满足的程度。根据东京郊区的ADL和认知障碍水平，从约27，000名65岁或65岁以上的人中筛选虚弱老年人的代表性样本。本研究共访问了1，323名体弱长者的主要照顾者，其中595人已完成访问，主要结果如下：总体而言，实施养老保险后，对老年人需求的满足程度有所提高。但是，从老年人及其照顾者的类型来看，某些类型的老年人的服务利用率有所下降。此外，在健康和社会服务利用方面，居家服务利用率有所上升，上门服务利用率有所下降。此外，照顾者对机构服务的需求增加，家庭照顾者的支持网络被削弱，而照顾者没有任何人可以咨询。此外，实施保险后，社会生活负担以及照顾者的身心负担并未减轻。

A purpose of the study is to compare the degree of meeting health and social service needs of the frail elderly between before and after implementing Japanese long term care insurance. A representative sample of the frail elderly are screened from about 27,000 persons who are sixty five years or older based on the level of ADL and cognitive disorders in a suburban area of Tokyo. 1,323 primary caregivers of these frail older persons ware interviewed and 595 has been completed.Major findings are as follows. Generally, the degree of meeting the needs of the frail elderly has been increased after imiplementing the insurance. However, according to the type of the frail elderly and their caregivers, the degree has been decreased with some of these types .In addition, in terms of the utilization of health and social services, the utilization of in-home services has been increased while the utilization of walk-in services has been decreased. Moreover, caregiver's requirement for the institutional services has been increased.The support network for family caregivers has been weakened while the caregiver who does not have any person to consult. Further, burden on social life as well as physical and psychological burden of the caregivers has not been decreased after implementing the insurance.