Abstract
Taking care of elderly people and bed-ridden patients, a population that is expected to increase, is becoming more and more of a serious problem. To circumvent this problem, various measures are actively being taken for care prevention in many institutions. The term “care prevention” means actions taken to avoid degeneration of function in the elderly that would necessitate care by others. Numerous local governments have provided programs for care prevention on a commercial basis and are developing these measures according to the characteristics of districts and elderly people therein. At present, various systems are used to evaluate outcomes of these measures. In this communication, we discuss an indicator to evaluate care prevention business from easily understood concepts.
The life expectancy at birth (or life expectancy) has been used as an overall indicator of the level of health and welfare within a district. Although life expectancy accurately represents the situation directly related to death, this indicator does not necessarily represent the situation related to the need for care. In contrast, the concept of “health expectancy” recently has been proposed, and attempts have been made to calculate values of the new indicator representing the level of health of the population within certain districts. Methods of calculation have been examined and now made open. Health and welfare levels are being analyzed using the new indicator in individual prefectures and in smaller districts within prefectures, cities, towns and villages. Hereafter, this indicator will be widely accepted to evaluate measures for care prevention.
As another social indicator related to measures for care prevention, geriatric medical expenses (medical expenses per elderly person) are frequently used. Geriatric medical expenses are calculated yearly, taking each local goverment as a unit. This indicator does not directly represent the health and welfare level in districts, however, because the indicator increases or decreases depending on numerous variables, such as the social security system, infrastructure of the medical and welfare system, and the size of the local goverment.
As another indicator, the good walker's index (Kenkyakudo) is used to evaluate the ability of individual elderly persons, the objects of care prevention. This represents a reduction in function of the lower extremities with aging and is easily understood by elderly people, because the ability to move in daily life is measured for this index. This index has been scientifically supported through examinations of its statistical relationship to diseases and physiological functions. Based on this index, it is possible to provide every elderly person with instructions concerning exercise and daily life for care prevention, while the ability of each person can be evaluated cross-sectionally in comparison with standards for the gender and age group of the particular person and individually according to changes over time in comparison with his or her previous records. With this index, it is also possible to detect problems specific to individual districts on the basis of its distribution specificity for groups of elderly people within the district. The good walker's index was conceived to be useful as a common indicator to evaluate measures taken for care prevention because it is closely associated with the daily life of elderly people.
