Abstract
Objectives The objectives of the present study were to classify 47 prefectures into clusters using mortality and disability data concerning elderly people in Japan, and to identify regional characteristics of each group using community healthcare welfare indicators.
Methods Weighted disability prevalence (WDP) was computed using determined utilities and prevalence of long-term care insurance. Prefectures were classified by hierarchical cluster analysis of life expectancy at age 65 years and age-adjusted WDP at the ages of 65-89 years, and discrimination of community healthcare welfare among clusters was examined using ANOVA and the Games-Howell pairwise comparison test. The characteristics of each group were then compared by means of differences among identified clusters.
Results Four clusters were identified: a long life expectancy low disability group, a long life expectancy high disability group, a short life expectancy low disability group, and a short life expectancy high disability group. For men, health expenditures for the elderly, long-term care insurance benefits and the number of doctors were significantly higher in the long life expectancy high disability group than in the short life expectancy low disability group (in order of indicators: P<0.01, P<0.05, P<0.01). Age-adjusted mortality rates from heart disease and stroke in men were significantly lower in the long life expectancy high disability group than in the short life expectancy low disability group (in order of indicators: P<0.01, P<0.001). For women, health expenditures for the elderly and long-term care insurance benefits were significantly higher in the long life high disability group than in the short life expectancy low disability group (both indicators: P<0.05). Cancer and heart disease mortality in women were significantly lower in the long life expectancy low disability group than in the short life expectancy high disability group (in order of indicators: P<0.05, P<0.01).
Conclusion Classification of prefectures in groups with similar regional characteristics, comparison among regions, and identification of group characteristics are useful for objective assessment of the present state of the regions, establishing policy goals, and objectively evaluating policy effectiveness.
