title: Health care and personal care needs among residents in nursing homes, group homes, and congregate housing in Japan: why does transition occur, and where can the frail elderly establish a permanent residence?
abstract: OBJECTIVE
  Japan has had high rates of transition to nursing homes from other long term care facilities. It has been hypothesized that care transitions occur because a resident's condition deteriorates. The aim of the present study was to compare the health care and personal care needs of residents in nursing homes, group homes, and congregate housing in Japan.
  
  
  METHODS
  The present study was conducted using a cross-sectional study design.
  
  
  METHODS
  The present study included 70,519 elderly individuals from 5 types of residential facilities: care medical facilities (heavy medical care; n = 17,358), geriatric intermediate care facilities (rehabilitation aimed toward a discharge to home; n = 26,136), special nursing homes (permanent residence; n = 20,564), group homes (group living, n = 1454), and fee-based homes for the elderly (congregate housing; n = 5007).
  
  
  METHODS
  The managing director at each facility provided information on the residents' health care and personal care needs, including activities of daily living (ADLs), level of required care, level of cognitive impairment, current disease treatment, and medical procedures.
  
  
  RESULTS
  A multinomial logistic regression analysis demonstrated a significantly lower rate of medical procedures among the residents in special nursing homes compared with those in care medical facilities, geriatric intermediate care facilities, group homes, and fee-based homes for the elderly. The residents of special nursing homes also indicated a significantly lower level of required care than those in care medical facilities.
  
  
  CONCLUSIONS
  The results of our study suggest that care transitions occur because of unavailable permanent residence option for people who suffer with medical deterioration. The national government should modify residential facilities by reorganizing several types of residential facilities into nursing homes that provide a place of permanent residence.
authors: Institute for Health Economics and Policy, Tokyo, Japan. Electronic address: mnakanishi-tky@umin.ac.jp.
authors: Miharu
authors: M
authors: Nakanishi
authors: Institute for Health Economics and Policy, Tokyo, Japan.
authors: Keiko
authors: K
authors: Hattori
authors: Institute for Health Economics and Policy, Tokyo, Japan.
authors: Taeko
authors: T
authors: Nakashima
authors: Institute for Health Economics and Policy, Tokyo, Japan.
authors: Kanae
authors: K
authors: Sawamura
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D016330:Frail Elderly; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D016852:Housing for the Elderly; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D012112:Residential Facilities
keywords: Frail elderly; Japan; group homes; intermediate care facilities; skilled nursing facilities