title: The association between the utilization of long-term care services and mortality in elderly Koreans.
abstract: It is necessary to confirm the effect of long-term care insurance (LTCI) by identifying changes in mortality, whether benefits are used or not, as well as the effects of in-home and institutional services on mortality. The goal of this study was to identify the association between service use and the mortality rate in elderly Koreans. We used Cox proportional hazard regression models and the Kaplan-Meier survival curve method to estimate the hazard ratio and survival probability for death while adjusting for covariates. We detected a 27.8% mortality rate at the 40-month follow-up period. Male gender, advanced age and activities of daily living were risk factors for mortality. In all models, the hazard ratio of participant death of those using long-term care services was significantly lower than for those who did not use these services. Among the service users, the hazard ratio for participant death of institutional service users was significantly higher than it was for in-home service users. This study also identified the impact of the transition from in-home services to institutional services. A primary goal of LTCI is to promote health and life stabilization in the elderly. To both delay and prevent institutionalization, it is necessary to develop assistive devices and effective in-home services and ensure access of these for elderly patients.
authors.affiliation: Institute of Health Insurance and Clinical Research, National Health Insurance Service Ilsan Hospital, Goyang, South Korea, South Korea.
authors.forename: Jung-Kyu
authors.initials: JK
authors.lastname: Choi
authors.affiliation: Health Insurance Policy Research Institute, National Health Insurance Service, Wonju, South Korea, South Korea. Electronic address: eui0505@nhis.or.kr.
authors.forename: Euisin
authors.initials: E
authors.lastname: Joung
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; 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; D053208:Kaplan-Meier Estimate; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D009026:Mortality; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis
keywords: Follow-up study; In-home service; Long-term care insurance; Mortality; Service use