Municipalities, which are the insurers of long-term care insurance, are expected to manage long-term care insurance systems using a data-based PDCA cycle. There is also a data environment in place that municipalities can utilize, one of which is “Hokenja-sheet” which collects basic data related to long-term care insurance. However, an analysis of the status of setting indicators for long-term outcomes in the 8th Long-Term Care Insurance Plan revealed that many municipalities face difficulties in managing the PDCA cycle and utilizing data. Logic models make it possible to visualize the relationship between the outcome and the program, clarifying indicators, and making it possible to analyze programs for improvement. Therefore, we have developed a logic model for the field of long-term care insurance and community comprehensive care systems, and have developed measures for effective utilization of “Hokenja-sheet.”
The logic model was developed through discussions with academic experts and local government officials, with reference to related laws, regulations, and official documents regarding long-term care insurance, comprehensive community care systems, and so on. The final outcome was one item related to the quality of life of the elderly, and the intermediate outcomes included three items: continuation of living at home, preventive care/social participation, and sustainability of long-term care insurance. Direct outcomes included 14 items related to service systems and support as well as long-term care insurance programs and costs. While the final and intermediate outcomes were highly versatile, it was considered desirable for the other outcomes to be set according to region and era.
We developed an evaluation tool that enables regional assessment by setting indicators from the “Hokenja-sheet” in the long-term care insurance basic logic model and displaying the data on the logic model. The data were formatted to allow for comparisons by country, prefecture, city, town, village, and time series. A training program has also been developed and tested.
We demonstrate a general-purpose logic model in the field of long-term care insurance. Together with the “Hokenja-sheet”, it is expected that the tools will be used to help administrative staff learn the basics of management using the PDCA cycle. It is expected that the effectiveness of using logic models will be verified and more effective tools and training programs will be developed.
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