A Study on the Evaluation Methodology of Home Care Environment for Elderly People in Local City

Analysis of Facility Location of Medical Care, Nursing Care and Long-term Care

Abstract

In order to achieve a reduction of medical care and long-term care expenses, the center of the health care and long-term care policies have been shifting to the region and home from the facility, and urgently needed to construction of Community-Based Comprehensive Care System in Japan. The roles of Primary Care Physician (PCP) is important providing to the comprehensive home-based care that assure the QOL in the elderly. It is necessary to examine the provision system of home care services with a focus on PCP. In japan, a home care support hospital and clinic (Home Care Support Services: HCSS) is provided as medical institutions to assume a role of those PCP.

Purpose of this study is to get the knowledge for the evaluation methodology of home-based care environment for elderly people. Methodology of this paper is analysis a general service-providing area of the home-based medical care and long-term care, and analysis about Area of Primary Care with a focus on HCSS in the perspective of the density of population and facility according to geographical characteristics.

In Tochigi prefecture, according to the cover rate of elderly population for each local authorities, the cover rate of mountainous and intermountain area is relatively lower than others. Burden on providing of home-based care service of HCSS (or PCP) is small in the urban area and suburban area, and that is large in the rural area and mountainous and intermountain area. Current situation of the large burden on the providing of home-based care service of HCSS (or PCP) is a serious problem in rural area and mountainous and intermountain area. After all in these areas, there is a situation that must rely on admission facilities such as special nursing home. It is a dilemma of Japan that has aimed to build the comprehensive community care system centered on the home life.