Determinants of long-term care insurance applications in South Korea

2020 ◽  
Author(s):  
Sunhee Park ◽  
Heejung Kim ◽  
Chang Gi Park
Keyword(s):  
Older Adults ◽  
South Korea ◽  
Long Term Care ◽  
Community Dwelling ◽  
Care Needs ◽  
Term Care ◽  
Factors Affecting ◽  
Long Term Care Insurance ◽  
The Government

Abstract Background South Korea established universal long-term care insurance (LTCI) in 2008. However, actual requests for LTCI remain lower than government estimates because some eligible candidates never apply despite their strong care needs. This study aimed to examine factors affecting LTCI applications for older, community-dwelling Koreans. Methods Both individual- and community-level data were obtained from a national dataset from the Korea Health Panel Survey and the Korea National Statistical Office (N = 523). Data were analyzed using multilevel modeling. Results Only 16.4% of older adults in need of care applied for LTCI. Those who applied were more likely to be older, report poor self-rated health, receive care from non-family caregivers, and have caregivers experiencing high levels of caregiving burden. Regional differences in LTCI applications existed concerning the financial condition of one’s community. Conclusions Our study findings emphasize that Korean LTCI should implement both individual and community strategies to better assist older adults in properly acquiring LTCI. The government should make comprehensive efforts to increase access to LTCI in terms of availability, quality, cost, and information by collaborating with local centers.

scholarly journals Range in systolic blood pressure and care-needs certification in long-term care insurance in community-dwelling older patients with chronic kidney disease

2017 ◽  
Vol 46 (1) ◽  
pp. 293-306 ◽  
Author(s):  
Taroh Himeno ◽  
Tazuo Okuno ◽  
Keisuke Watanabe ◽  
Kumie Nakajima ◽  
Osamu Iritani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Older Patients ◽  
Long Term Care ◽  
Community Dwelling ◽  
Care Needs ◽  
Term Care ◽  
Long Term Care Insurance ◽  
Older Subjects

Objective Low systolic blood pressure (SBP) is associated with an increased risk for cardiovascular morbidity/mortality in older patients with chronic kidney disease (CKD). The present study evaluated the association between range in blood pressure and first care-needs certification in the Long-term Care Insurance (LTCI) system or death in community-dwelling older subjects with or without CKD. Methods CKD was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2 or dipstick proteinuria of + or greater. Our study was conducted in 1078 older subjects aged 65–94 years. Associations were estimated using the Cox proportional hazards model. Results During 5 years of follow-up, 135 first certifications and 53 deaths occurred. Among patients with CKD, moderate SBP (130–159 mmHg) was associated with a significantly lower adjusted risk of subsequent total certification (hazard ratio [HR] = 0.44) and subsequent certification owing to dementia (HR = 0.17) compared with SBP < 130 mmHg. These relationships were not observed in non-CKD subjects. Conclusion Lower SBP of <130 mmHg may predict a higher risk for subsequent first care-needs certification in LTCI, especially for dementia, in community-dwelling patients with CKD.

Physical Frailty and Future Costs of Long-Term Care in Older Adults: Results from the NCGG-SGS

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Hyuma Makizako ◽  
Hiroyuki Shimada ◽  
Kota Tsutsumimoto ◽  
Keitaro Makino ◽  
Sho Nakakubo ◽  
...  
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Community Dwelling ◽  
Physical Frailty ◽  
Care Needs ◽  
Frailty Phenotype ◽  
Term Care ◽  
Frailty Status ◽  
Community Dwelling Older Adults

<b><i>Introduction:</i></b> Frailty is associated with adverse outcomes, but few studies have determined associations between the frailty phenotype and measures of healthcare burden, including long-term care insurance (LTCI) costs, in older community-dwelling populations. <b><i>Objective:</i></b> The aim of this study was to examine the association between frailty status and subsequent LTCI costs in Japanese community-dwelling older adults. <b><i>Methods:</i></b> The prospective data were from a cohort study (National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes [NCGG-SGS]). The participants were community-dwelling older adults (mean age 71.8 years, women 50.7%) participating in an NCGG-SGS baseline examination held between August 2011 and February 2012 in Obu, Japan (<i>N</i> = 4,539). At baseline, we assessed the physical frailty phenotype using the Japanese version of the CHS criteria and categorized it as robust, pre-frail, or frail. We also ascertained care-needs certification and total costs using long-term care services in Japan’s public LTCI system during the 29 months. <b><i>Results:</i></b> During the 29-month follow-up period, 239 participants (5.3%) required the LTCI system’s care-needs certification and 163 participants (3.6%) used LTCI services. Participants classified as frail (odds ratio 5.85, 95% confidence interval 3.54–9.66) or pre-frail (2.40, 1.58–3.66) at the baseline assessment had an increased risk of requiring care-needs certification compared with robust participants. The mean total costs for LTCI services during the 29 months were ¥6,434 ($63.1) for robust, ¥19,324 ($189.5) for pre-frail, and ¥147,718 ($1,448.2) for frail participants (1 US dollar = 102 Japanese yen in July 2014). There were significantly higher costs associated with advancing frailty status. Individual frailty components (slowness, weakness, exhaustion, low activity, and weight loss) were also associated with higher total costs for using LTCI services. <b><i>Discussion/Conclusion:</i></b> Frail community-dwelling older adults had a higher risk of requiring the LTCI system’s care-needs certification and the subsequent total LTCI costs.

scholarly journals Do Walking-Friendly Built Environments Influence Frailty and Long-Term Care Insurance Service Needs?

2021 ◽  
Vol 13 (10) ◽  
pp. 5632
Author(s):  
Seigo Mitsutake ◽  
Tatsuro Ishizaki ◽  
Yuri Yokoyama ◽  
Mariko Nishi ◽  
Mohammad Javad Koohsari ◽  
...  
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Educational Status ◽  
Community Dwelling ◽  
Service Needs ◽  
Term Care ◽  
Neighborhood Walkability ◽  
Walk Score ◽  
Long Term Care Insurance

Our study examined the associations between neighborhood walkability, frailty, and the incidence of long-term care insurance (LTCI) service needs using a prospective cohort survey in a suburban town in Japan. The final sample for analyses comprised 2867 community-dwelling older adults (mean age: 73.0 years). Neighborhood walkability was measured using the Walk Score®. A total of 387 participants (13.5%) exhibited frailty. The odds of frailty, adjusted for the covariates (sex, age, educational status, marital status, residential status, employment status, subjective economic status) among participants who lived in somewhat walkable/very walkable areas, was 0.750 (95% Confidence Interval, CI: 0.597–0.943) versus those who lived in car-dependent areas. During the 23-month follow-up, 102 participants needed LTCI services (19.0 per 1000 person-years), 41 of whom (21.0 per 1000 person-years) lived in car-dependent areas, and 61 of whom (17.9 per 1000 person-years) lived in somewhat walkable/very walkable areas. As compared with participants who lived in car-dependent areas, the incidence of LTCI service needs was not significantly lower than that of those who lived in somewhat walkable/very walkable areas. Walk Score® can provide the critical information for the strategies to improve walkability and prevent older adults’ frailty in less walkable areas, contributing to achieving the United Nation’s Sustainable Development Goals (SDGs).

scholarly journals Socio-Economic Predictors of Hiring Live-In Migrant Care Workers to Support Community Dwelling Older Adults with Long-Term Care Needs: Recent Evidence from a Central Italian Region

2021 ◽  
Vol 13 (10) ◽  
pp. 5349
Author(s):  
Oliver Fisher ◽  
Paolo Fabbietti ◽  
Giovanni Lamura
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Community Dwelling ◽  
Care Needs ◽  
Term Care ◽  
Financial Barriers ◽  
Need Of Care ◽  
Care Workers ◽  
Economic Predictors

To meet the rising demand for home care, many families in Italy hire live-in migrant care workers (MCWs). However, the reliance on MCWs to provide long-term care (LTC) and a lack of alternative formal care services raises concerns around equality in access to care. This study aimed to determine the socio-economic predictors of hiring live-in MCWs among older adults with LTC needs in Italy, the objective care burden placed on MCWs, and the financial barriers that people in need of care and informal caregivers face when hiring MCWs, analysing data from a cross-sectional questionnaire with 366 older adults with LTC needs and their primary family caregivers living in the Marche region. Binary logistic regression was used to calculate the predictors of hiring a live-in MCW. Having a primary caregiver that had a high school education or above significantly increased the odds of hiring a live-in MCW (Odds Ratio (OR) = 3.880), as did receiving a social pension (OR = 2.258). Over half (57.5 percent) of the people in need of care had difficulties in affording the costs of hiring an MCW in the past year. To increase the sustainability of the Italian MCW market and reduce socio-economic barriers to accessing care, the Italian Government should increase funding for LTC benefits and add means testing and restrictions on the use of cash-for-care allowances.

scholarly journals Aging-In-Place Preference and Institutionalization Among Japanese Older Adults: A 7-Year Longitudinal Study

2021 ◽  
Author(s):  
Takeshi Nakagawa ◽  
Taiji Noguchi ◽  
Ayane Komatsu ◽  
Masumi Ishihara ◽  
Tami Saito
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Aging In Place ◽  
Place Preference ◽  
Community Dwelling ◽  
Term Care ◽  
Insurance System ◽  
Long Term Care Insurance ◽  
Japanese Older Adults

Abstract Background In Asia, where autonomous decision-making is not well accepted, little is known about whether and how individuals’ preferences are considered when deciding where they receive care. This study examined the longitudinal association of aging-in-place preference when bedridden with institutionalization among Japanese older adults. Methods We analyzed nationally representative data of 1,290 community-dwelling older adults aged 70 and above, applying the multiple imputation method. Baseline data were collected in 1999, shortly before the long-term care insurance system was introduced. The outcome was measured as self- or proxy-reported years of institutionalization over seven years. The explanatory variable was the aging-in-place preference. Participants were asked about their desired place of care (facility, home, or other) when bedridden. Covariates were sociodemographic and health-related factors. We used Cox proportional hazards models and calculated hazard ratios (HRs) with 95% confidence intervals (CIs) to evaluate the association of aging-in-place preference when bedridden with institutionalization. Results Seventy-eight respondents (6.0%) were institutionalized during the follow-up period. Compared to individuals preferring to reside in long-term care facilities when bedridden (48.7%), those preferring to stay in their homes (39.6%) were less likely to be institutionalized, even after adjusting for relevant covariates (HR = 0.46, 95% CI 0.27–0.79 for model 1 including residential status; HR = 0.45, 95% CI 0.27–0.76 for model 2 including marital status and co-resident children). Conclusions Our findings suggest that individuals’ aging-in-place preferences are considered under the long-term care insurance system. Individuals’ preferences should be shared by families and clinicians when deciding the place of care.

scholarly journals Physical Activity and Sarcopenia in Community-Dwelling Older Adults with Long-Term Care Insurance

2021 ◽  
Vol 11 (4) ◽  
pp. 1610-1618
Author(s):  
Masahiro Kitamura ◽  
Kazuhiro P. Izawa ◽  
Kodai Ishihara ◽  
Hiroaki Matsuda ◽  
Soichiro Okamura ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Roc Curve ◽  
Long Term Care ◽  
Community Dwelling ◽  
Analysis Of Covariance ◽  
Term Care ◽  
Long Term Care Insurance ◽  
Community Dwelling Older Adults

The present study aimed to clarify the difference in physical activity (PA) due to sarcopenia in community-dwelling older adults with long-term care insurance (LTCI). This was a cross-sectional study that investigated data of 97 consecutive community-dwelling older Japanese adults with LTCI who underwent rehabilitation at one day care center in Japan from November 2018 to May 2019. Sarcopenia was determined according to criteria of the Asian Working Group for Sarcopenia. Unpaired t-test, Mann-Whitney U test, chi-square test and analysis of covariance were used to compare participant characteristics and clinical parameters between the older adults with and without sarcopenia. A receiver operating characteristic (ROC) curve was constructed to determine the cut-off value of PA for sarcopenia. The sarcopenia group (n = 20) had significantly lower body mass index (BMI), skeletal muscle mass index, gait speed, and PA than those in the no sarcopenia group (n = 28) (p < 0.05). After adjustment for BMI and sex, the sarcopenia group showed significantly lower PA than the no sarcopenia group. Findings showed that the cut-off value of PA indicating sarcopenia by ROC curve analysis was 1494.4 steps/day (p < 0.05); this value may aid in identifying sarcopenia in older adults with LTCI.

scholarly journals Characteristics of patients discontinuing outpatient services under long-term care insurance and its effect on frailty during COVID-19

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11160
Author(s):  
Tamaki Hirose ◽  
Yohei Sawaya ◽  
Takahiro Shiba ◽  
Masahiro Ishizaka ◽  
Ko Onoda ◽  
...  
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Walking Speed ◽  
Community Dwelling ◽  
Outpatient Rehabilitation ◽  
Rehabilitation Services ◽  
Term Care ◽  
Long Term Care Insurance ◽  
Community Dwelling Older Adults

Background Among community-dwelling older adults who require long-term care and use outpatient rehabilitation services, we aimed to examine the characteristics of patients who discontinued using outpatient rehabilitation services to prevent exposure to COVID-19 and the effects of this discontinuation on patient frailty. Methods Participants were 119 older adults (69 males, 50 females; average age 77.3 ± 8.3 years) requiring long-term care who used outpatient rehabilitation services. Our outpatient rehabilitation service involved day care for older adults undergoing rehabilitation including pick-up and drop-off services under the long-term care insurance system. They were divided into two groups: participants who discontinued using outpatient rehabilitation services and participants who continued their use. To find the factors associated with this discontinuation, binomial logistic regression analysis was performed, in which the following independent variables were used: gender, age, height, weight, long-term care level, grip strength, and normal walking speed. Frailty status was investigated in April 2020 and again in September 2020 through interviews and telephone surveys utilizing the Frailty Screening Index. Results Women and normal walking speed were independent factors associated with the discontinuation of outpatient rehabilitation due to COVID-19. According to the results of the Frailty Screening Index, similar tendencies were exhibited in both April and September. The discontinued group indicated that they were getting less exercise and having stronger feelings of fatigue than the continuing group. Conclusions The findings are in accordance with other studies indicating that women are more likely to employ prevention measures against COVID-19, as seen among the community-dwelling older adults requiring long-term care who used outpatient rehabilitation services. People with higher levels of physical function were also likely to refrain from using outpatient rehabilitation services. Results further suggested that the discontinued group had more frailty-related factors (i.e., low physical activity and strong exhaustion) than the continuing group.

scholarly journals Trends in Life Expectancy With Care Needs Based on Long-term Care Insurance Data in Japan

2012 ◽  
Vol 22 (3) ◽  
pp. 238-243 ◽  
Author(s):  
Rumi Seko ◽  
Shuji Hashimoto ◽  
Miyuki Kawado ◽  
Yoshitaka Murakami ◽  
Masayuki Hayashi ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Long Term Care Insurance ◽  
Insurance Data

scholarly journals Standard Error of the Mean and Minimal Detectable Change of Gait Speed in Older Adults Using Japanese Long-Term Care Insurance System

2021 ◽  
Vol 7 ◽  
pp. 233372142110489
Author(s):  
Yui Takada ◽  
Shigeharu Tanaka
Keyword(s):  
Older Adults ◽  
Standard Error ◽  
Gait Speed ◽  
Long Term Care ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Term Care ◽  
Long Term Care Insurance ◽  
The Mean

Evaluation of motor function, such as gait ability, can accurately predict the subsequent occurrence of disability in older adults. There are no reports of standard error of the mean (SEM) or minimal detectable change (MDC) with respect to gait in Japanese long-term care insurance-certified individuals. The purpose of this study was to investigate the values of preferred gait, fast gait, and the timed up and go (TUG) test. This study included 46 participants using the Japanese long-term care insurance system. (age 86.5 ± 6.6 years, 12 men, 34 women). The duration of three gait were measured twice using a stopwatch. The SEM was 0.07 for preferred gait, 0.09 for fast gait and 2.59 for TUG. The MDC was 0.19 for preferred gait, 0.26 for fast gait, and 7.17 for TUG. The SEM and MDC values of preferred gait, fast gait, and TUG in this study corroborated with those of previous studies, whereas others were different. Considering that gait speed differs with the country, it may be difficult to compare it among different population groups. We obtained the results of gait speed of Japanese long-term care insurance-certified individuals, which is a new finding

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