The effectiveness of long-term care services offered prior to care recipients' home death

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K24161
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0908:Society medicine, nursing, and related fields
• Research Institution: The University of Tokyo
• Principal Investigator: Abe Kazuhiro 東京大学, 大学院医学系研究科(医学部), 特任研究員 (40850037)
• Project Period (FY): 2019-08-30 – 2022-03-31
• Keywords: 高齢者 / 死亡場所 / 在宅看取り / 終末期 / 介護 / 介護給付費等実態統計 / 人口動態調査

Outline of Final Research Achievements

Even though 55% of the Japanese people 55 years and older express the wish to spend the end of their life at home, the country has a low proportion of in-home death (13.2%in 2017). This study found that accessibility of in-home medical care and in-home care services in the municipality of residence was partially responsible for whether or not care-dependent older persons could spend their final days at home. In addition, the use of in-home care services by care-dependent older people at the end of life was positively associated with in-home death. Therefore, municipal policymakers will need to enhance the provisioning system of in-home medical care and in-home care services and improve residents' access to them to fulfill the wishes of older adults for their final place of residence.

Free Research Field

公衆衛生学

Academic Significance and Societal Importance of the Research Achievements

本研究の結果は、自治体の政策担当者が地域医療計画や介護保険事業計画を通して、住民の在宅医療・居宅介護サービスへのアクセスを向上させることによって、要介護高齢者の在宅死の望みを支援することができる可能性を示している。日本は他国と比較して在宅死亡割合が低く、最期まで自宅で療養したい高齢者が多いにも関わらず在宅死が遂げられていない者が多い現状を鑑みると、入院病床や介護施設サービスの充実を目指す以上に在宅医療と居宅介護サービスの充実が必要だろう。そして、制度の財政的持続可能性や人的資源確保の実現可能性を考慮したさらなる研究も必要である。