Mortality differences in disabled older adults by place of care in Japan: nationwide 10-year results

Tomoko Ito, Mikiya Sato*, Hideto Takahashi, Chihiro Omori, Yuta Taniguchi, Xueying Jin, Taeko Watanabe, Haruko Noguchi, Nanako Tamiya




This longitudinal study aimed to compare 1-year mortality between users of home- and community-based services (HCBS) and residential facilities (nursing homes, group homes, and geriatric apartments) among non-hospitalized frail older adults in Japan. Using three nationwide data sources, we conducted a nationwide pooled cohort study of 1-year follow-up among certified users of long-term care insurance (LTCI) aged 65 years and older from 2007 through 2016 to compare 1-year mortality using a logistic regression model. Overall, compared to HCBS users, mortality was higher in residents in nursing homes and geriatric apartments but lower in group home residents. While mortality gradually increased over time among those in residential facilities, it remained at a level similar to that of HCBS users. Since 2006, Japan’s public health policy has been to increase end-of-life care in residential facilities. Our results indicate that this policy resulted in an increase in mortality in residential facilities, possibly due to accommodation of more severely ill people there, or a shift in their focus from transferring dying residents to hospitals to preserve the dignity of residents.

ジャーナルJournal of Public Health Policy
出版ステータスPublished - 2022 12月

ASJC Scopus subject areas

  • 健康政策
  • 公衆衛生学、環境および労働衛生


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