TY - JOUR
T1 - Mortality differences in disabled older adults by place of care in Japan
T2 - nationwide 10-year results
AU - Ito, Tomoko
AU - Sato, Mikiya
AU - Takahashi, Hideto
AU - Omori, Chihiro
AU - Taniguchi, Yuta
AU - Jin, Xueying
AU - Watanabe, Taeko
AU - Noguchi, Haruko
AU - Tamiya, Nanako
N1 - Funding Information:
The Ministry of Health, Labour, and Welfare supported this study: Health and Labour Sciences Research Grant, Japan; Comprehensive Research on Aging and Health (H30-choju-ippan-007). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Funding Information:
Funding was provided by Ministry of Health, Labour and Welfare (Grant No. H30-choju-ippan-007).
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2022/12
Y1 - 2022/12
N2 - 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.
AB - 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.
KW - Long-term care
KW - Mortality
KW - Place of care
KW - Residential aged care
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U2 - 10.1057/s41271-022-00369-3
DO - 10.1057/s41271-022-00369-3
M3 - Article
C2 - 36307550
AN - SCOPUS:85140835252
SN - 0197-5897
VL - 43
SP - 542
EP - 559
JO - Journal of Public Health Policy
JF - Journal of Public Health Policy
IS - 4
ER -
