HASHIMOTO Hideki University of Tokyo, Graduate School of Medicine, professor (50317682)
YANO Eiji Teikyo University, School of Medicine, professor (50114690)
ISHIKAWA Hirono Shiga University of medical Science, 医学部, Associate Professor (40384846)
TAMIYA Nanako University of Tsukuba, Graduate School of Comprehensive Human Sciences, 教授 (20236748)
|Budget Amount *help
¥6,570,000 (Direct Cost: ¥6,000,000、Indirect Cost: ¥570,000)
Fiscal Year 2007: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
Fiscal Year 2006: ¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 2005: ¥2,200,000 (Direct Cost: ¥2,200,000)
Informal care by family members still plays an important role in home care after acute stroke. We investigated the clinical and demographic factors, such as family structure, that predict discharge to home and length of hospital stay (LOS) after acute stroke hospitalization. The sex, age, family structure before stroke, activities of daily living (ADL) function at discharge, discharge destination, and LOS of stroke patients (114 cerebral infarctions and 44 intracerebral hemorrhages) admitted to a neurosurgical hospital were reviewed. In the logistic regression analysis, low ADL function was significantly associated with discharge to a destination other than home. Of the patients discharged home, low ADL function was strongly associated with LOS in the multiple regression analysis. In addition, living with a spouse only had the opposite effect on LOS in men and women. LOS tended to be shorter for men with a wife, but longer for women with a husband. The structure and gender roles in a stroke patient's household may need further attention for the efficient use of hospital resources.
We examined the impact of social engagement and other predictive factors, including disability, household composition, and formal services. on continuity in home care of the elderly in need of care. Data were collected form elderly living in the community who were certified as eligible for care level 2-5 under Japanese long-term care insurance. Continuity in home care was defined as a participant living at home 1 year after study initiation. Of 244 participants, 200 continued to receive home care (82%). Based on a logistic regression analysis predicting continuity in home care, after controlling for gender, age, initial care level, household composition, and daycare service use, having friends was significantly associated with continuity in home care. The promotion of social engagement may be important in preventing institutionalization.