Research regarding the effects of long-term care service plans using systems for estimating the details of long-term care

2004 Fiscal Year Final Research Report Summary

• Project/Area Number: 14510253
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: 社会学(含社会福祉関係)
• Research Institution: National Institute of Public Health
• Principal Investigator: TSUTSUI Takako National Institute of Public Health, Dept.of Social Services, Dr.Eng.Chief.Administration on Social Services Section, 福祉サービス部福祉マネジメント室, 室長 (20300923)
• Project Period (FY): 2002 – 2004
• Keywords: Long-term care insurance system / Long-term care service / care plan / prediction system

Research Abstract

The purpose of this research is to improve upon the "Long-term care service volume prediction system" developed in 2000,to create a long-term care service plan using a "Long-term care detail estimation system" that automatically calculates a "Long-term care detail estimation table" indicating the occurrence rate for care services required by individual seniors, and to analyze the changes in the status of seniors requiring long-term care over the period of years during which this plan is executed, as well as the details of care services provided during this time based on the plan. Specifically, based on data regarding long-term care need certification and data regarding care services provided over the four years since the implementation of the long-term care insurance system, we clarified the combinations of care services provided in two groups-a group of seniors requiring care for whom a plan was created using the system, and a group of seniors requiring care for whom a plan was create d without using the system. We also clarified the patterns of care services provided based on specific conditions surrounding the seniors in both groups.
According to the results of the analysis, there was no notable difference in the volume of care services provided in the two groups. This is because most of the seniors in the group in which the system was used received a volume of care services that reflected the upper limit of provision values as specified by the long-term care insurance system, which was in excess of required volume of services as calculated by the system.
Following the implementation of the long-term care insurance system, the volume of services provided and the scope of those services increased in both groups with each passing year. There was a particular increase in the use of "shared lifestyle care for seniors with dementia (group homes)" and loans of welfare devices that were not deemed necessary based on calculations by the system. This trend became particularly evident following the amendment to compensation for care workers in 2003.
In an investigation of combinations of care services often used and of the changes in the state of the seniors requiring care, we found a trend indicating a deterioration in the level of care needs among the seniors in question. Especially notable was a trend that followed the amendment to compensation for care workers, in which there was an increase in the number of seniors using combinations of care services (e.g., outpatient care, loan of welfare devices, and group homes), but at the same time a deterioration in the level of care needs among the seniors using multiple services in this way.
These results suggest two things : (1)Users have a strong tendency to use larger volumes of care services than deemed necessary by the system's calculations ; and (2)These usage volumes are influenced not by the volumes actually required, but by the upper limit of service provision value. The results of this study have shown that most seniors requiring long-term care are receiving a larger volume and a greater variety of care services than those deemed necessary by the calculations of the Long-term care service volume prediction system, and that as a result, a large percentage of the persons receiving such excessive services are suffering from deteriorating conditions.