title: Long-term care-service use and increases in care-need level among home-based elderly people in a Japanese urban area.
abstract: OBJECTIVE
  The objective of this study was to examine the effects of home-based long-term care insurance services on an increase in care need levels and discuss its policy implications.
  
  
  METHODS
  We analyzed care need certification and long-term care service use data for 3006 non-institutionalized elderly persons in a Tokyo ward effective as of October 2009 and 2010. Individual care need assessment intervals and their corresponding changes in care need level were calculated from data at two data acquisition points of care need assessment. Those who had been certified but did not use any long-term care insurance service were defined as the control group. The Cox proportionate hazard model was used to determine whether the use of a long-term care insurance service is associated with increased care need level.
  
  
  RESULTS
  After adjusting for sex, age, and care need level, the hazard ratio for the probability of increased care need level among service users was calculated as 0.75 (95% confidence interval, 0.64-0.88; p < 0.001).
  
  
  CONCLUSIONS
  Home-based long-term care service use may prevent an increase in care need level. Administrative data on care need certification and services use could be an effective tool for evaluating the long-term care insurance system.
authors: Department of Planning, Information and Management, The University of Tokyo Hospital, Japan. koikes@adm.h.u-tokyo.ac.jp
authors: Soichi
authors: S
authors: Koike
authors: Yuji
authors: Y
authors: Furui
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006291:Health Policy; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D007353:Insurance, Long-Term Care / Q000706:statistics & numerical data; D007564:Japan; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D014505:Urban Population / Q000706:statistics & numerical data