Older Adults Used Fewer Home Care Services During The COVID-19 Pandemic: Findings From A Secondary Analysis Of An Urgent Survey In Japan (original) (raw)
Related papers
Change of Use in Community Services among Disabled Older Adults during COVID-19 in Japan
International Journal of Environmental Research and Public Health
During the COVID-19 pandemic, social interactions were restricted, including community services for disabled older adults. This study aimed to describe the change of use in community services related to long-term care insurance (LTCI) during the pandemic in Japan. A retrospective descriptive study was conducted using data collected via a cloud-based management support platform for older adult care provider “Kaipoke”, by a private-sector company “SMS Co., Ltd.”, in which care-managers of LTCI manage their office work. Data collection occurred from July 2019 to June 2020. Study subjects were LTCI service users aged 65 years and above. Subjects were living at home. We examined changes in the number of users of LTCI services before and after the COVID-19 pandemic began, using an interrupted time-series analysis. Results indicated that the use of outpatient services was reduced; however, home-visit services were maintained. The decrease in use was significant in the seven prefectures whe...
medRxiv, 2020
Objective We compared the use of various care services and institutional deaths in older adults among these facility types. Design This was a retrospective cohort study. Methods We used administrative claim data from April 2014 to March 2017. The study participants comprised Fukuoka Prefecture residents aged 75 and older with certified care needs of level 3 or more in April 2014 and who received home care services during the study period. Participants were divided into 4 groups according to the facility type from which they received home care services: General Clinics, Home Care Support Clinics and hospitals (HCSCs), Enhanced HCSCs with beds and Enhanced HCSCs without beds. The outcomes were utilization of medical and long-term care services and the incidence of institutional deaths. We constructed generalized linear regression models. The evaluated potential risk factors were sex, age, care needs levels, and Charlson comorbidity index (CCI) scores. Results The numbers of inpatient ...
BMC Research Notes
Objective Home care is one of the essential community health care services; thus, identifying changes of home care utilization before and during the COVID-19 pandemic would be useful for researchers and policymaker to reconsider the home care system, the support needed for home care staff, and the collaborative system with hospitals in the COVID-19 era. We conducted a multicenter cross-sectional web-based anonymous survey of the directors of home visit facilities in Japan in August 2021. Results A total of 33 participants from 37 facilities responded to the survey. The number of patients dying at home and newly requested home visits increased during the COVID-19 pandemic (74.2%, 71.0%). One possible reason was the restricted visitation of inpatient facilities (93.5%). The underlying disease that the largest number of participants perceived as having increased compared with before the COVID-19 pandemic was cancer (51.6%). There were no significant differences in being in a rural area...
BMC Health Services Research, 2010
Background: To maintain the sustainability of public long-term care insurance (LTCI) in Japan, a preventive care policy was introduced in 2006 that seeks to promote active improvement in functional status of elderly people who need only light care. This policy promotes the use of day care services to facilitate functional improvement, and contains the use of home help services that provide instrumental activity of daily living (IADL) support. However, the validity of this approach remains to be demonstrated. Methods: Subjects comprised 241 people aged 65 years and over who had recently been certified as being eligible for the lightest eligibility level and had began using either home help or day care services between April 2007 and October 2008 in a suburban city of Tokyo. A retrospective cohort study was conducted ending October 2009 to assess changes in the LTCI eligibility level of these subjects. Cox's proportional hazards model was used to calculate the relative risk of declining in function to eligibility Level 4 among users of the respective services. Results: Multivariate analysis adjusted for factors related to service use demonstrated that the risk of decline in functional status was lower for users of home help services than for users of day care services (HR = 0.55, 95% CI: 0.31-0.98). The same result was obtained when stratified by whether the subject lived with family or not. Furthermore, those who used two or more hours of home help services did not show an increase in risk of decline when compared with those who used less than two hours.
BMJ Open, 2021
ObjectivesWe compared the care services use and medical institutional deaths among older adults across four home care facility types.DesignThis was a retrospective cohort study.SettingWe used administrative claims data from April 2014 to March 2017.ParticipantsWe included 18 347 residents of Fukuoka Prefecture, Japan, who received home care during the period, and aged ≥75 years with certified care needs of at least level 3. Participants were categorised based on home care facility use (ie, general clinics, Home Care Support Clinics/Hospitals (HCSCs), enhanced HCSCs with beds and enhanced HCSCs without beds).Primary and secondary outcome measuresWe used generalised linear models (GLMs) to estimate care utilisation and the incidence of medical institutional death, as well as the potential influence of sex, age, care needs level and Charlson comorbidity index as risk factors.ResultsThe results of GLMs showed the inpatient days were 54.3, 69.9, 64.7 and 75.0 for users of enhanced HCSCs ...
BMC Health Services Research
Background To meet the increasing demand for home healthcare in Japan as the population ages, home care support clinics/hospitals (HCSCs) and enhanced HCSCs were introduced in 2006 and 2012, respectively. This study aimed to evaluate whether enhanced HCSCs fulfilled the expected role in home healthcare. Methods We conducted a retrospective cohort study using linked medical and long-term care claims data from a municipality in Japan. Participants were ≥ 65 years of age, had newly started regular home visits between July 2014 and March 2018, and used either conventional or enhanced HCSCs. Patients were followed up for one year after they started regular home visits or until the month following the end of the regular home visits if they ended within one year. The outcome measures were (i) emergency home visits at all hours and on nights and holidays at least once, respectively, (ii) hospitalization at least once, and (iii) end-of-life care, which was evaluated based on the place of dea...
Sustainability, 2021
The COVID-19 pandemic has been dramatically affecting the life of older adults with care needs and their family caregivers. This study illustrates how the initial outbreak of the pandemic changed the supply of formal and informal care to older adults in European countries and Israel and assesses the resilience of these countries in providing support to their older populations by means of a mix of both types of care. We subjected data from the Survey of Health, Ageing and Retirement in Europe COVID-19 period (SHARE-COVID-19) across 23 European countries (including Israel) to descriptive and cluster analyses. In the first wave of the outbreak, a significant proportion of older adults in European countries received informal help, with an increase in the frequency of informal help received from children, neighbors, friends, or colleagues and a decrease in that received from other relatives. In most countries, difficulties in receiving home care services from professional providers were ...
Home Health Care Management & Practice
Home health and home care (HH&HC) agencies provide essential medical and supportive services to elders and people with disabilities, enabling them to live at home. Home-based care is an important alternative to facility-based care, especially for infection prevention during the COVID-19 pandemic. The majority of the HH&HC workforce is comprised of aides, who also are vulnerable to COVID-19. There are limited data on the COVID-19 experience of HH&HC agencies, clients and aides. A survey of Massachusetts HH&HC agency managers was conducted June 1 to 30, 2020 to assess the impact of COVID-19 on agencies, clients, and aides early in the pandemic and to identify needs for future pandemic planning. Of the 94 agencies with completed surveys, most (59.6%) provided services to clients with COVID-19 and 3-quarters (73.7%) employed aides who tested positive for COVID-19, were symptomatic, and/or quarantined. Most agencies (98.7%) experienced a decrease in demand for home visits, reflecting cli...
Social Science Japan Journal, 2007
demand for home-visit care services. In addition, with the comprehensive enactment of the Revised Long-Term Care Insurance Law (Kaisei Kaigo Hoken H o) in April 2006, the types of services needed, including preventive care, treatment of dementia and so forth, are becoming more specialized and sophisticated. Moreover, in 2007, a national audit of major home-visit care service providers was conducted for the first time ever. 2 The audit revealed inappropriate management conduct on the part of the service providers, and even forced the largest provider to withdraw from the market. All in all, the trend for reinforced monitoring and improvement of service quality is growing strongly. In other words, not only are the needs for home-visit care expected to expand but also its quality can be predicted to improve as well. In order to respond flexibly to the growing need for home-visit care, it is important to take home helpers into consideration, as well as users and providers of the services. This is because in order to consistently provide home-visit care services of suitable levels, adequate numbers of workforce need to be secured. Furthermore, the workforce needs training so that it is equipped to provide highquality care services. Recruiting and retaining an adequately educated and skilled workforce, and improving the quality of staff, are policy issues shared by other member nations of the Organization for Economic Cooperation and Development (OECD) as well (OECD 2005a). Therefore, examining strategies for securing and improving the quality of the workforce in Japan, based on the current state of the country's home helpers, may also contribute to the improvement and maintenance of longterm care quality in other OECD countries. 3 2. The Long-Term Care Insurance Service Market in Japan This section introduces the background regarding the adoption of the Long-Term Care Insurance System in Japan and presents an overview of the system. It also presents an outline of the long-term care insurance service market. 2.1 The Aging Society and Its Long-Term Care Policies Since the 1990s, the population of Japan has aged rapidly, and the country's birth rate has been declining at equivalent speed. In 2006, the total fertility rate was 1.32 (Ministry of Health, Labour and Welfare 2007b), the average life expectancy 79.0 years for men and 85.8 years for women (Ministry of Health, Labour and Welfare 2007c) and the ratio of the elderly (i.e. the ratio of the population of those 65 and over to the total population) was 20.5% for the total population of 127.77 million.
Micro data analysis of medical and long-term care utilization among the elderly in Japan
International journal of environmental research and public health, 2010
Japan is currently experiencing the most rapid population aging among all OECD countries. Increasing expenditures on medical care in Japan have been attributed to the aging of the population. Authors in the recent debate on end-of-life care and long-term care (LTC) cost in the United States and Europe have attributed time to death and non-medical care cost for the aged as a source of rising expenditures. In this study, we analyzed a large sample of local public insurance claim data to investigate medical and LTC expenditures in Japan. We examined the impact of aging, time to death, survivorship, and use of LTC on medical care expenditure for people aged 65 and above. On the basis of these findings, we conclude that age is a contributing factor to the rising expenditures on LTC, and that the contribution of aging to rising medical care expenditures should be distinguished according to survivorship.