Operation of Appropriate Nutritional Management Services in Long-Term Care Health Facilities for Older Adults: Relationship between the Number of Different Types of Dietary Forms and Labor Productivity

<p>Objective: In Long-Term Care Health Facilities for older adults (hereafter LCHF), providing patients with meals adjusted to their feeding and swallowing functions (a dysphagia diet) is essential. The Japanese Dysphagia Diet 2021 by the JSDR Dysphagia Diet Committee (JDD2021), an index of dietary forms of a dysphagia diet, classified dietary forms into five levels. This study aimed to understand the actual situation regarding the number of different types of dietary forms (hereafter referred to as "the number of dietary forms") and labor productivity provided in LCHF.</p><p>Methods: A survey was distributed to 4,133 LCHF nationwide in 2020, and data from 956 facilities that responded were analyzed. A Kruskal-Wallis test was used to examine the association between the number of dietary forms and labor productivity (meals/person/meal).</p><p>Results: Labor productivity was significantly higher in facilities that produced more meals (p < 0.001). The median of the number of dietary forms provided in LCHF was five (range 1~28) for main meals and five (range 1~26) for side meals (main and side dishes), which was similar to the 5 levels of academic classification. No significant relationship was observed between the number of dietary forms and labor productivity (staple food: p = 0.52; side dish (main and side dish): p = 0.90). Approximately 80% of the facilities implemented "cut vegetables, pre-prepared foods, and ready-made foods," regardless of the number of dietary forms.</p><p>Conclusion: Labor productivity was higher when the number of meals produced was higher, which suggested that the scale of production was related to the number of meals produced. Labor productivity did not differ from that of facilities that served small number of dietary forms, even when the number of dietary forms served exceeded the five levels of the JSDR dysphagia diet committee's classification and six or more types were offered. Facilities that served large number of dietary forms managed to prevent a decline in labor productivity by innovating with menu items and food materials.</p>