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长期护理保险实施前后虚弱老人对健康和社会服务需求的满足程度。根据东京郊区的ADL和认知障碍水平，从大约2.7万名65岁或以上的人中筛选出具有代表性的虚弱老年人样本。对这些体弱老年人的1323名主要照顾者进行了访谈，595名已经完成。主要调查结果如下。总体而言，实施该保险后，多病老年人的需求满足程度有所提高。然而，根据体弱老年人及其照顾者的类型，其中一些类型的程度有所下降。此外，在卫生和社会服务的利用方面，居家服务的利用有所增加，而无预约服务的利用有所下降。此外，照顾者对机构服务的需求增加，对家庭照顾者的支持网络被削弱，而没有人咨询的照顾者。此外，实施保险后，照顾者的社会生活负担以及身体和心理负担并未减轻。

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.