2011 Volume 21 Issue 2 Pages 175-187
As life expectancy among the elderly has improved, increases in health care spending and care methods have become issues in many developed countries. The present study examined health care costs for disabled elderly with a focus on care location.
A total of 226 inhabitants (age, over 65 years) of a town in Hokkaido, whose Care Needs Levels were classified by Long-Term Care Insurance and who were covered by National Health Insurance, participated in this study.
We considered three care locations for disabled elderly : home, LTC facilities and chronic hospitals. We performed generalized liner model (GLM) with log link for the subjects of home and LTC facilities, in order to determine which factor affected health care costs. The dependent variable was health care cost, and independent variables were age, gender, Care Needs Level, and hospital length of stay. Age and hospital length of stay were treated as continuous variables, and the other variables were treated as dummy variables. We described health care cost for the subjects in chronic hospitals by Care Needs Level and length of hospital stay, because the number of those was too small to conduct multivariate analysis.
Institutional costs accounted for 74% of health care costs. Care Needs Level and hospital length of stay were factors significantly associated with health care costs, particularly with respect to home and LTC facilities.
It has been suggested that preventing Care Needs Level becoming more severe and prolonging home care could be effective for reducing health care cost. But it may be said that we should consider the family status of the disabled elderly at the selection of care location.