Accumulated long-term care benefits by risk assessment scales for incident functional disability: A six-year follow-up study of long-term care receipt data

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  • SAITO Masashige
    Faculty of Social Welfare, Nihon Fukushi University Center for Well-being and Society, Nihon Fukushi University
  • TSUJI Taishi
    Faculty of Health and Sport Sciences, University of Tsukuba
  • FUJITA Kinya
    Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology
  • KONDO Naoki
    Department of Social Epidemiology and Global Health, Graduate School of Medicine and School of Public Health, Kyoto University
  • AIDA Jun
    Department of Oral Health Promotion, Tokyo Medical and Dental University
  • OJIMA Toshiyuki
    Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine
  • KONDO Katsunori
    Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology Center for Preventive Medical Sciences, Chiba University

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Other Title
  • 要支援・要介護リスク評価尺度点数別の累積介護サービス給付費：介護保険給付実績の6年間の追跡調査より
  • ヨウ シエン ・ ヨウカイゴリスク ヒョウカ シャクド テンスウ ベツ ノ ルイセキカイゴサービス キュウフヒ : カイゴ ホケン キュウフ ジッセキ ノ 6ネンカン ノ ツイセキ チョウサ ヨリ

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Abstract

<p>Objectives　This study aims to evaluate the differences in the cumulative benefit costs of public long-term care [LTC] insurance services, using a risk assessment scale score, which predicts incident functional disability among older people.</p><p>Methods　A baseline survey was conducted in 2010 involving individuals aged 65 and above from 12 municipalities in Japan who were not eligible for public LTC insurance benefits (response rate: 64.7%). Using public LTC claim records, we followed LTC service costs among 46,616 individuals over a period of about six years (up to 76 months). We used risk assessment scales to assess incident functional disability (0-48). We adopted a classical linear regression model, Tobit regression model, and linear regression with multiple imputation for missing values.</p><p>Results　Overall, 7,348 (15.8%) of the participants had used LTC services during the follow-up period. The risk assessment score for incident functional disability was positively associated with the cumulative costs of LTC services per person, length of usage period of LTC services, and proportion of people certified for long-term care/support need and for over long-term care level 2. After adjusting for confounding variables, the six-year cumulative costs of LTC services were around JPY 31.6 thousand higher per point of risk score (95% confidence interval [CI]: 28.3 to 35.0). The costs were around JPY 8.9 thousand (95%CI: 6.5 to 11.3)higher in the low score group (risk score ≤ 16), and JPY 75.3 thousand (95%CI: 67.4 to 83.1) higher in the high score group (risk score ≥ 17). When we adopted other estimated models, the major results and trends were not largely different.</p><p>Conclusions　In this study, the risk assessment scale score could estimate subsequent LTC benefit costs. Community interventions to improve and maintain variable aspects of risk assessment scores may help contribute to a reduction in public LTC benefits within municipalities.</p>

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