2021 Volume 6 Pages 1-14
【Purpose of research】 In order to continue an independent life in old age, it is necessary to understand the factors related to the deterioration of the degree of care required and take measures against them. In this study, we attempted to clarify the factors related to the deterioration of the degree of long-term care using the accredited questionnaire data, medical insurance and long-term care insurance claim data.
【Materials and methods】 We have created a database that links long-term care insurance certification survey data, long-term care insurance claim data, and medical insurance claim data in one municipality in eastern Japan on an individual basis. From this database, 11,658 home-based subjects who were certified as requiring nursing care level 1 in 2014 were extracted, tracked until 2017, and using the variables related to ADL dependency, injury and illness that can be grasped in the database, and provided long term care insurance services. Factors related to the deterioration of the degree were examined by logistic regression analysis.
【Results】 As a result of the analysis, as ADL dependency status, the following cases showed statistically significant deterioration of dependency degree; those who are not independent in items related to muscle weakness such as turning over, getting up, holding a sitting position, standing on both feet and one foot, walking, transferring, and moving, those who went out less frequently and depended on others for shopping had a worsening level of care, those who use welfare equipment in the medical and long-term care services they are using have deteriorated. This last result can be interpreted as “people who are in a state of using welfare equipment" at high risk. As injuries and illnesses, dependent degree were significantly worse in those with lower limb joint disorders and spinal disorders. Among the medical and long-term care services used, the rate of deterioration was significantly lower for those who used home-visit nursing care for both medical insurance and long-term care insurance.
【Discussion and Conclusion】 As a result of this study, it was suggested that prevention of muscle weakness and continuous care from the viewpoint of nursing are effective in preventing deterioration of the degree of care required.
