Assessment of needs of long-term care for frail elderly persons in a community and factors related to types of institutinal care

1.在大阪府米诺市对188名体弱和居家老人(居家组)、61名住院6个月以上的老年患者(住院组)和72名体弱老人福利院居民(住院组)进行了三项研究。对三个群体的特点和社会背景进行了比较。每组中约有30%的人中风。ADL评分，家庭组以中度残疾为主，住院组以重度残疾为主，居民组以轻度残疾为主。在住院组和住院组中，独居和没有配偶的人的比例明显高于居家组。居民组中与子女生活在一起的受试者明显少于家庭组或住院组。在居民群体中，没有自己住房的人所占比例最高。采用Hayashi‘s数量化方法II进行多因素分析，比较家庭组和住院组的病例。两组间的差异与ADL、性别、是否独居、是否与子女同住、是否有配偶等变量有关。家庭组和居民组之间的多因素分析显示，后者以独居和没有自己家的人为主。在居住条件和家庭构成方面存在差异。研究发现，为了制定老年人健康和福利计划，每个市政当局应评估社区的总体社会需求，包括长期住院病人和福利院居民的需求，以及居家居民的需求。

1. Three studies were carried out in Mino City, Osaka Prefecture, on 188 frail and elderly persons living at home (the home group), 61 elderly patients who had been hospitalized for more than six months (the inpatient group), and 72 residents of welfare homes for the frail elderly (the resident group). The characteristics and social backgrounds of the three groups were compared.2. About 30% of each group had suffered a stroke. As for ADL score, moderate disability was dominant in the home group, severe disability in the inpatient group, and slight disability in the resident group. The proportions of those who had been living alone and those who had no spouse were significantly higher in the inpatient group and in the resident group than in the home group. Significantly fewer subjects in the resident group had been living with their offspring than in the home group or in the inpatient group. The percentage of those who did not have their own home was the highest for the resident group.3. Multivariate analysis using Hayashi's quantification method II were conducted for a comparison between cases belonging to the home group and the inpatient group. Differences between these two groups were related to such variables as ADL, sex, living or not living alone, living or not living with offspring, and having or not having a spouse.4. Multivariate analysis between the home group and the resident group showed that the latter group was dominated by those living alone, and not having their own home. Difference was observed in the condition of the dwelling and constitution of the family.5. It was found that in order to create a health and welfare plan for the elderly, each municipality should assess overall social needs in the community, including the needs of long-stay hospital patients and residents of welfare homes as well as the needs of those living at home.