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Research article
Takahiro Mori
Health Services Research and Development Center, University of Tsukuba
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0216-2284
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
To evaluate the effects of prevention services provided by long-term care insurance (LTCI) for older adults who require support from LTCI in Kashiwa City, Japan
Methods
We conducted an analysis using the following population-based longitudinal data in Kashiwa City between April 2012 and March 2015: Data of National Health Insurance and LTCI claims, the survey for certification of LTCI, the register, and premium tier classification. All data was linked using the pre-assigned anonymous identifying numbers. We analyzed the Cox regression model using the time for the deteriorations of long-term care levels as an outcome and the use of preventive care services as the primary exposure among participants aged 75 years or older, who had either support levels 1 or 2 at the beginning of this analysis. The study was further stratified by both age and initial support level.
Results
The final analysis included 1,289 participants. The primary result showed, among all participants, that preventive service was not effective (hazard ratio 0.96, 95% confidence interval 0.78-1.19). In our sub-analysis, the preventive service was effective in avoiding deteriorations only among those aged 85 and older with support level 1 (HR 0.65, 95% CI 0.43-0.97) out of four groups.
Conclusions
The preventive services of LTCI in Kashiwa City showed a significant effect on the deterioration among subjects aged 85 or older, whose disabled level were low (support level 1). Our results suggest that the prevention services provided by LTCI may not be effective for all older individuals; to provide these services efficiently, local governments, as insurers of LTCI, will need to identify the specified groups that may benefit from the preventive services.
Keywords
Prevention services, Community care, Older adults, Long-term care insurance
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Editorial decision: Major revision
On 08 Nov, 2020
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Received 07 Nov, 2020
Review #1 received
Received 31 Oct, 2020
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Reviewer #4 agreed
On 19 Oct, 2020
Review #3 received
Received 19 Oct, 2020
Reviewer #3 agreed
On 18 Oct, 2020
Reviewer #2 agreed
On 17 Oct, 2020
Reviewer #1 agreed
On 13 Oct, 2020
Reviewers invited
Invitations sent on 12 Oct, 2020
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A new preprint design is coming!
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This preprint is under consideration at BMC Health Services Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Takahiro Mori
Health Services Research and Development Center, University of Tsukuba
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0216-2284
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 05 Oct, 2020
No community comments so far
Editorial decision: Major revision
On 08 Nov, 2020
Review #2 received
Received 07 Nov, 2020
Review #1 received
Received 31 Oct, 2020
Review #4 received
Received 20 Oct, 2020
Reviewer #4 agreed
On 19 Oct, 2020
Review #3 received
Received 19 Oct, 2020
Reviewer #3 agreed
On 18 Oct, 2020
Reviewer #2 agreed
On 17 Oct, 2020
Reviewer #1 agreed
On 13 Oct, 2020
Reviewers invited
Invitations sent on 12 Oct, 2020
Editor assigned
On 27 Sep, 2020
Submission checks complete
On 26 Sep, 2020
Editor invited
On 26 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
To evaluate the effects of prevention services provided by long-term care insurance (LTCI) for older adults who require support from LTCI in Kashiwa City, Japan
Methods
We conducted an analysis using the following population-based longitudinal data in Kashiwa City between April 2012 and March 2015: Data of National Health Insurance and LTCI claims, the survey for certification of LTCI, the register, and premium tier classification. All data was linked using the pre-assigned anonymous identifying numbers. We analyzed the Cox regression model using the time for the deteriorations of long-term care levels as an outcome and the use of preventive care services as the primary exposure among participants aged 75 years or older, who had either support levels 1 or 2 at the beginning of this analysis. The study was further stratified by both age and initial support level.
Results
The final analysis included 1,289 participants. The primary result showed, among all participants, that preventive service was not effective (hazard ratio 0.96, 95% confidence interval 0.78-1.19). In our sub-analysis, the preventive service was effective in avoiding deteriorations only among those aged 85 and older with support level 1 (HR 0.65, 95% CI 0.43-0.97) out of four groups.
Conclusions
The preventive services of LTCI in Kashiwa City showed a significant effect on the deterioration among subjects aged 85 or older, whose disabled level were low (support level 1). Our results suggest that the prevention services provided by LTCI may not be effective for all older individuals; to provide these services efficiently, local governments, as insurers of LTCI, will need to identify the specified groups that may benefit from the preventive services.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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