Inequality in preferred place of care among community-dwelling older people

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K21468
• Project/Area Number (Other): 18H06389 (2018)
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund (2019); Single-year Grants (2018)
• Review Section: 0908:Society medicine, nursing, and related fields
• Research Institution: Kyoto University (2020-2021); The University of Tokyo (2018-2019)
• Principal Investigator: Haseda Maho 京都大学, 医学研究科, 特定助教 (30821996)
• Project Period (FY): 2018-08-24 – 2022-03-31
• Keywords: 社会経済的状況 / 高齢者 / 終末期 / 希望する死亡場所 / 話し合い / かかりつけ医 / ソーシャル・サポート

Outline of Final Research Achievements

Among the community-dwelling older people, a higher percentage of the group with lower educational attainment indicated "unsure" of their preferred place of death compared to those with higher educational attainment. In addition, a higher percentage of those in low-income groups did not have that discussion compared to those in high-income groups. On the other hand, those who perceived stronger ties to the community, such as community attachment and receiving social support, tended to prefer to die at home (Ishikawa, 2021). Moreover, among those 75 years of age or older, those who had a primary care physician tended to have more opportunities to discuss with others where they wanted to die than those who did not have primary care physicians(Moriki, 2021). Furthermore, the difference in the percentage of discussions between income groups tended to be smaller when they had a primary care physician.

Free Research Field

社会疫学

Academic Significance and Societal Importance of the Research Achievements

本研究では希望する最期の場所に関する話し合いの実施について、所得階層間での格差が確認された。その一方で、かかりつけ医の存在や地域とのつながりはその話し合いを促進する要因であり、特にかかりつけ医は所得によるその格差を縮小できる可能性があることが示唆された。高齢者の人生の最終段階での過ごし方の選択を支援し、どのような社会的背景を持つ人であっても、本人が望む形で人生を終えられるような仕組みづくりを進める際には、地域の文脈および社会背景を踏まえた情報提供などの配慮や、かかりつけ医や地域のつながりなどの資源の活用も有用かもしれない。