Skip to main content
Log in

Predictors of continuity in home care for the elderly under public long-term care insurance in Japan

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background and aims: 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Friedman SM, Steinwachs DM, Rathouz PJ, Burton LC, Mukamel DB. Characteristics predicting nursing home admission in the program of all-inclusive care for elderly people. Gerontologist 2005; 45: 157–66.

    Article  PubMed  Google Scholar 

  2. Mustard C, Finlayson M, Derksen S, Berthelot JM. What determines the need for nursing home admission in a universally insured population? J Health Serv Res Policy 1999; 4: 197–203.

    PubMed  CAS  Google Scholar 

  3. Kersting RC. Impact of social support, diversity, and poverty on nursing home utilization in a nationally representative sample of older Americans. Soc Work Health Care 2001; 33: 67–87.

    Article  PubMed  CAS  Google Scholar 

  4. Foley DJ, Ostfeld AM, Branch LG, Wallace RB, McGloin J, Cornoni-Huntley JC. The risk of nursing home admission in three communities. J Aging Health 1992; 4: 155–73.

    Article  PubMed  CAS  Google Scholar 

  5. Yaffe K, Fox P, Newcomer R et al. Patient and caregiver characteristics and nursing home placement in patients with dementia. JAMA 2002; 287: 2090–7.

    Article  PubMed  Google Scholar 

  6. Vernooij-Dassen M, Felling A, Persoon J. Predictors of change and continuity in home care for dementia patients. Int J Geriatr Psychiatry 1997; 12: 671–7.

    Article  PubMed  CAS  Google Scholar 

  7. McCann JJ, Hebert LE, Li Y et al. The effect of adult day care services on time to nursing home placement in older adults with Alzheimer’s disease. Gerontologist 2005; 45: 754–63.

    Article  PubMed  Google Scholar 

  8. Severson MA, Smith GE, Tangalos EG et al. Patterns and predictors of institutionalization in community-based dementia patients. J Am Geriatr Soc 1994; 42: 181–5.

    PubMed  CAS  Google Scholar 

  9. Greene VL, Ondrich JI. Risk factors for nursing home admissions and exits: a discrete-time hazard function approach. J Gerontol 1990; 45: S250–8.

    Article  PubMed  CAS  Google Scholar 

  10. Rozzini L, Cornali C, Chilovi BV, Ghianda D, Padovani A, Trabucchi M. Predictors of institutionalization in demented patients discharged from a rehabilitation unit. J Am Med Dir Assoc 2006; 7: 345–9.

    Article  PubMed  Google Scholar 

  11. Cohen CA, Gold DP, Shulman KI, Wortley JT, McDonald G, Wargon M. Factors determining the decision to institutionalize dementing individuals: a prospective study. Gerontologist 1993; 33: 714–20.

    Article  PubMed  CAS  Google Scholar 

  12. Giles LC, Glonek GF, Luszcz MA, Andrews GR. Effect of social networks on 10-year survival in very old Australians: the Australian Longitudinal Study of Aging. J Epidemiol Community Health 2005; 59: 574–9.

    Article  PubMed  Google Scholar 

  13. Mendes de Leon CF, Glass TA, Berkman LF. Social engagement and disability in a community population of older adults: the New Haven EPESE. Am J Epidemiol 2003; 157: 633–42.

    Article  PubMed  Google Scholar 

  14. Mendes de Leon CF, Gold DT, Glass TA, Kaplan L, George LK. Disability as a function of social networks and support in elderly African Americans and Whites: the Duke EPESE 1986–1992. J Gerontol B Psychol Sci Soc Sci 2001; 56: S179–90.

    Article  PubMed  CAS  Google Scholar 

  15. Michael YL, Berkman LF, Colditz GA, Kawachi I. Living arrangements, social integration, and change in functional health status. Am J Epidemiol 2001; 153: 123–31.

    Article  PubMed  CAS  Google Scholar 

  16. Glass TA, Mendes de Leon CM, Marottoli RA, Berkman LF. Population-based study of social and productive activities as predictors of survival among elderly Americans. BMJ 1999; 319: 478–83.

    Article  PubMed  CAS  Google Scholar 

  17. Steinbach U. Social networks, institutionalization, and mortality among elderly people in the United States. J Gerontol 1992; 47: S183–90.

    Article  PubMed  CAS  Google Scholar 

  18. Static and Information Department Minister’s Secretariat, Ministry of Health, Labour and Welfare. Statistical Abstracts on Health and Welfare in Japan. Health and Welfare Statistics Association 2006: 22.

  19. Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 1980; 20: 649–55.

    Article  PubMed  CAS  Google Scholar 

  20. Hillen T, Schaub R, Hiestermann A, Kirschner W, Robra BP. Self-rating of health is associated with stressful life events, social support and residency in East and West Berlin shortly after the fal of the wall. J Epidemiol Community Health 2000; 54: 575–80.

    Article  PubMed  CAS  Google Scholar 

  21. House JS, Landis KR, Umberson D. Social relationships and health. Science 1988; 241: 540–5.

    Article  PubMed  CAS  Google Scholar 

  22. Kawachi I, Colditz GA, Ascherio A et al. A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA. J Epidemiol Community Health 1996; 50: 245–51.

    Article  PubMed  CAS  Google Scholar 

  23. Vogt TM, Mullooly JP, Ernst D, Pope CR, Hollis JF. Social networks as predictors of ischemic heart disease, cancer, stroke and hypertension: incidence, survival and mortality. J Clin Epidemiol 1992; 45: 659–66.

    Article  PubMed  CAS  Google Scholar 

  24. Bennett KM. Low level social engagement as a precursor of mortality among people in later life. Age Ageing 2002; 31: 165–8.

    Article  PubMed  Google Scholar 

  25. Guilley E, Pin S, Spini D, d’Epinay CL, Herrmann F, Michel JP. Association between social relationships and survival of Swiss octogenarians. A five-year prospective, population-based study. Aging Clin Exp Res 2005; 17: 419–25.

    Article  Google Scholar 

  26. Hebert R, Dubois MF, Wolfson C, Chambers L, Cohen C. Factors associated with long-term institutionalization of older people with dementia: data from the Canadian Study of Health and Aging. J Gerontol A Biol Sci Med Sci 2001; 56: M693–9.

    Article  PubMed  CAS  Google Scholar 

  27. Scott WK, Edwards KB, Davis DR, Cornman CB, Macera CA. Risk of institutionalization among community long-term care clients with dementia. Gerontologist 1997; 37: 46–51.

    Article  PubMed  CAS  Google Scholar 

  28. Pot AM, Deeg DJ, Knipscheer CP. Institutionalization of demented elderly: the role of caregiver characteristics. Int J Geriatr Psychiatry 2001; 16: 273–80.

    Article  PubMed  CAS  Google Scholar 

  29. Di Bari M, Pecchioli A, Mazzaglia G et al. Care available to severely disabled older persons living at home in Florence, Italy. Aging Clin Exp Res 2008; 20: 31–9.

    Article  PubMed  Google Scholar 

  30. Kobayashi Y, Reich MR. Health care financing for the elderly in Japan. Soc Sci Med 1993; 37: 343–53.

    Article  PubMed  CAS  Google Scholar 

  31. Ikegami N, Campbell JC. Medical care in Japan. N Engl J Med 1995; 333: 1295–9.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kazuhiro Ohwaki MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ohwaki, K., Hashimoto, H., Sato, M. et al. Predictors of continuity in home care for the elderly under public long-term care insurance in Japan. Aging Clin Exp Res 21, 323–328 (2009). https://doi.org/10.1007/BF03324922

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03324922

Keywords

Navigation