Association of household income with home-based rehabilitation and home help service utilization among long-term home care service users

被引：13

作者：

Tsuchiya-Ito, Rumiko ^{[1
,2
]}

Ishizaki, Tatsuro ^{[1
]}

Mitsutake, Seigo ^{[1
]}

Hamada, Shota ^{[3
,4
]}

Yoshie, Satoru ^{[3
,4
,5
,6
,7
]}

Iijima, Katsuya ^{[5
,7
]}

Tamiya, Nanako ^{[4
,8
]}

机构：

[1] Tokyo Metropolitan Inst Gerontol, Human Care Res Team, Itabashi Ku, 35-2 Sakae Cho, Tokyo 1730015, Japan

[2] Dia Fdn Res Ageing Soc, Tokyo, Japan

[3] Assoc Hlth Econ Res & Social Insurance & Welf, Res Dept, Inst Hlth Econ & Policy, Tokyo, Japan

[4] Univ Tsukuba, Hlth Serv Res & Dev Ctr, Ibaraki, Japan

[5] Univ Tokyo, Inst Gerontol, Tokyo, Japan

[6] Keio Univ, Sch Med, Dept Hlth Policy & Management, Tokyo, Tokyo, Japan

[7] Univ Tokyo, Inst Future Initiat, Ibaraki, Japan

[8] Univ Tsukuba, Fac Med, Dept Hlth Serv Res, Ibaraki, Japan

来源：

BMC GERIATRICS | 2020年 / 20卷 / 01期

关键词：

Aging; Economic status; Long-term care services; Claims data; Two-part model; HEALTH-CARE; SUPPORT;

D O I：

10.1186/s12877-020-01704-7

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Background To examine the association of household income with home-based rehabilitation and home help services in terms of service utilization and expenditures. Methods A secondary data analysis of cross-sectional design was conducted using long-term care (LTC) insurance claims data, medical claims data, and three types of administrative data. The subjects comprised LTC insurance beneficiaries in Kashiwa city, Japan, who used long-term home care services in the month following care needs certification. Household income was the independent variable of interest, and beneficiaries were categorized into low-income or middle/high-income groups based on their insurance premiums. Using a two-part model, the odds ratios (ORs) and 95% confidence intervals (CIs) for the utilization of home-based rehabilitation and home help services in the month following care needs certification were estimated using logistic regression analysis, and the risk ratios (RRs) of service expenditures were estimated using a generalized linear model for gamma-distributed data with a log-link function. Results Among 3770 subjects, 681 (18.1%) used home-based rehabilitation and 1163 (30.8%) used home help services. There were 1419 (37.6%) low-income subjects, who were significantly less likely to use (OR: 0.813; 95%CI: 0.670-0.987) and spend on (RR: 0.910; 95%CI: 0.829-0.999) home-based rehabilitation services than middle/high-income subjects. Conversely, low-income subjects were significantly more likely to use (OR: 1.432; 95%CI: 1.232-1.664) but less likely to spend on (RR: 0.888; 95%CI: 0.799-0.986) home help services than middle/high-income subjects. Conclusion Household income was associated with the utilization of long-term home care services. To improve access to these services, the LTC insurance system should examine ways to decrease the financial burden of low-income beneficiaries and encourage service utilization.

引用

页数：16