2021 Volume 10 Issue 1-2 Pages 1-6
Introduction: Existing evidence on the effectiveness of interventions for frailty is limited, and it is not known if long-term care insurance services affect changes in the level of care. This study aimed to investigate the relationship between the type of long-term care services used and changes in care level among Japanese individuals ≥65 years old described in a nationwide administrative database in Japan who were unstable when first certified for a care level.
Methods: This was a retrospective cohort study using certification of needed support data and long-term care insurance claim data stored in the Long-term Care Insurance Comprehensive Database by the Ministry of Health, Labour, and Welfare. We identified elderly people aged ≥65 years who were first certified as needing care level 1 because of their unstable condition between April 2016 and March 2017. We then evaluated which types of long-term care services improved care level.
Results: In total, 15,981 elderly people were included in this study. There were apparent differences between the nonimproving and improving groups in sex (women: 48% vs. 63%, respectively) and cognitive, mental, or behavioral disorders (33% vs. 20%, respectively). Multivariate analysis showed significant correlations between cognitive, mental, or behavioral disorders and worsening of the needed care level (OR=0.49; 95% CI=0.45-0.54; p < 0.001). There was also a significant correlation between using day service for rehabilitation after first certification and improvement of care level (OR=1.27; 95% CI=1.13-1.42; p < 0.001).
Conclusions: Our study findings suggested that including rehabilitation in elderly individual's care plans improved their condition. Our results also suggested that the presence of cognitive, mental, or behavioral disorders could interfere with improvement.
