Predictors of continuity in home care for the elderly under public long-term care insurance in Japan.
OBJECTIVE
With the rapid increase in the elderly population, the number of people requiring care is also increasing and the capacity of the family to provide care is decreasing. Because institutionalization costs are high, more research is needed to investigate predictors of preventing institutionalization. The aim of this study was to examine the impact of social engagement and other predictive factors, including disability, household composition, and formal services, on continuity in home care of the elderly.


METHODS
The study was retrospective longitudinal in design. Data were collected from elderly people living in the community who were certified as eligible for care level 2-5 under Japanese long-term care insurance. Continuity in home care was defined as a participant living at home 1 year after the beginning of the study.


RESULTS
Of 244 participants, 200 continued to receive home care (82%). Based on a logistic regression analysis predicting continuity in home care, after controlling for gender, age, initial care level, household composition, and daycare service use, having friends was significantly associated with continuity in home care (odds ratio [OR] 2.42; 95% confidence interval [CI] 1.04-5.65). Participants who lived alone or with a spouse were less likely to continue to receive home care compared with those who lived with others (OR 0.27; 95% CI 0.08-0.87 and OR 0.18; 95% CI 0.06-0.53, respectively).


CONCLUSIONS
Having friends was a significant predictor of continuity in home care. The promotion of social engagement may be important in preventing institutionalization.
Ohwaki
Kazuhiro
K
Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga Itabashi, Tokyo 173-8605, Japan. ns-waki@med.teikyo-u.ac.jp
Hashimoto
Hideki
H
Sato
Mikiya
M
Tamiya
Nanako
N
Yano
Eiji
E
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology; D003266:Continuity of Patient Care / Q000592:standards / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000592:standards / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data; D007353:Insurance, Long-Term Care / Q000706:statistics & numerical data*; D007398:Interpersonal Relations; D007564:Japan; D008134:Long-Term Care / Q000191:economics*; D010003:Osteoarthritis / Q000453:epidemiology; D011237:Predictive Value of Tests; D012919:Social Behavior; D020521:Stroke / Q000453:epidemiology