Transition of functional decline and long-term and health care service utilization until the death on ambulatory frail older adults

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K19831
• Research Category: Grant-in-Aid for Challenging Research (Exploratory)
• Allocation Type: Multi-year Fund
• Research Field: Society medicine, Nursing, and related fields
• Research Institution: Osaka City University
• Principal Investigator: Kono Ayumi 大阪市立大学, 大学院看護学研究科, 教授 (00313255)
• Co-Investigator(Kenkyū-buntansha): 石原 拓磨 岐阜大学, 医学部附属病院, 助教 (00783193) ; 山本 紘司 横浜市立大学, 医学部, 准教授 (10548176) ; 金子 勝規 大阪市立大学, 大学院経済学研究科, 教授 (10708085)
• Project Period (FY): 2017-06-30 – 2020-03-31
• Keywords: 要支援高齢者 / 要介護化 / 入所 / 死亡 / 疾患

Outline of Final Research Achievements

The study aimed to examine the impact of disease on the care-need level decline, institutionalization, and death over a five-year period among ambulatory frail older adults certified as Support Level by long-term care insurance (LTCI). Subjects were 1,658 elders aged 65 years and older, who were newly certified as Support Level in the fiscal year 2012. We collected the LTCI certification information, the receipt of LTCI, and healthcare insurance until March 2017. The analyses, adjusted for demographic characteristics and service utilization in the study period, showed that more men died than women and the diseases related to their death differed from when they were originally certified as Support Level. Older adults with dementia were more likely to be institutionalized and their care-need level tended to decline. The results showed that having cancer or arthritis and/or osteoporosis as comorbidities with dementia might facilitate institutionalization and care-need level decline.

Free Research Field

地域・老年看護学

Academic Significance and Societal Importance of the Research Achievements

介護保険制度において高齢者が要支援と初めて認定されたときから死亡に至るまで，どのような疾患を有し，どのように医療・介護を利用しているのか，5年間の医療給付や介護給付の連結データの分析を行った．その結果，要支援高齢者の疾患管理の有用性や医療と介護が連携した介護予防の必要性が示唆された．