MODELING OF HOME WELFARE SERVICES FOR THE AGED IN DEPOPULATED AREA

目的：利用日本东北地区400个城市的数据，调查老年人家庭福利服务利用程度与社会经济因素和暴雪地区特征的相关性。研究对象与方法：采用逐步正演方法，采用多元回归分析方法，探讨家庭助残服务、短期住院服务和一日服务的利用程度与人口统计、经济状况和医疗设施可及性等18项指标的相关性。其次，采用方差分析的方法，研究了暴雪地区排名分组与家庭福利服务综合评价指标之间的相关性。结果：“人均支出”、“收入差异”、“65岁以上人口结构比率”和“三次产业从业人员比率”与城市间家庭福利服务综合评价指标的差异相关。100名65岁以上长者每年使用日间服务的平均日数，以及各大雪区排名组别对家居福利服务的整体评价指数，均有显著差异。然而，在100名65岁以上老人每年使用家居援助服务或短期住宿服务的平均天数，以及在大雪地区排名组别之间的家居福利服务综合评价指数，并无显著差异。结论：日本各城市在老年人福利服务方面存在差异，不仅是因为老龄化、财政状况、经济优势地区位置、产业结构等因素的差异，还因为各地区的降雪量存在差异。

Objective: Correlations of the degree of utilization of home welfare services for the aged with socioeconomic factors and with characteristics of areas with heavy snowfalls were investigated using data obtained from 400 municipalities in the Tohoku district of Japan. Subjects and methods: Correlations of degrees of utilization of home assistance services, short stay services and one-day services with 18 indices of population statistics, economic conditions and availability of medical facilities were investigated by multiple regression analysis using the stepwise forward method.Next, correlations between ranked groups of heavy snowfall areas and indices for overall evaluation of home welfare services were investigated using analysis of variance.Results: "Expenditures per person", "income differences", "ratios of population structure for people aged over 65 years" and "ratios of people working in three sectors of secondary industry" were found to be related to differences between municipalities in the indices for overall evaluation of home welfare services. Significant differences were found in the mean number of days per year the one-day services were used by 100 people over 65 years of age and in the indices for overall evaluation of home welfare services between the ranked groups of heavy snowfall areas. However, no significant differences were found in the mean number of days per year the home assistance services or short stay services were used by 100 people over 65 years of age and in the indices for overall evaluation of home welfare services between the ranked groups of heavy snowfall areas.Conclusions: Differences between municipalities in Japan in welfare services for the aged have arisen not only because of differences in factors such as aging, financial conditions, location of economically favorable areas, and industry structure but also because of differences in the amount of snowfall in the area.