Impact of Outpatient Rehabilitation Service in Preventing the Deterioration of the Care-Needs Level Among Japanese Older Adults Availing Long-Term Care Insurance: A Propensity Score Matched Retrospective Study

Abstract

Outpatient rehabilitation (OR) and outpatient day long-term care (ODLC) services are frequently used by older adult patients in Japan. However, there is a need to clarify that OR service, which has more rehabilitation professionals than ODLC, has the role of providing rehabilitation. This retrospective study examined the impact of OR services by comparing the two services based on City A data from the care-needs certification survey conducted between 2015 to 2017. We performed a propensity score matched analysis to compare the changes in the care level and function of OR and ODLC users after two years. The results showed that OR users showed a lower deterioration in care levels and less decline in the activities of daily living (ADL) in dementia and adaptation to social life. In the analysis of older adults requiring support, OR users had a lower deterioration in care levels and less decline in the ADL in dementia and behavioral and psychological symptoms than ODLC users did. There was no difference between the two services with respect to older adults requiring long-term care. The OR service has had an increasingly preventive effect on the deterioration of care levels compared to the ODLC service, which was particularly evident in older adults requiring support.

Long-Term Changes in Older Adults’ Independence Levels for Performing Activities of Daily Living in Care Settings: A Nine-Year Follow-Up Study

“…In the second stage, a committee of physicians and other healthcare professionals determines the ranking of individuals based on their care needs. Then, individuals who qualify for long-term care are able to receive the appropriate benefits, while the services provided are divided into two categories: long-term care benefits (care needs levels 1 to 5) and prevention benefits (support levels 1 and 2) [ 27 ].…”

“…Depending on the degree of assistance required, all items were scored from 1 to 4—except for Grooming, as its items were scored from 1 to 3. Higher scores indicated a lower daily functioning ability in that item and an increased need for assistance [ 27 ]. Based on these scores, participants were classified according to whether they were independent (obtaining a score of 1) or not (obtaining a score of 2–4).…”

Prioritizing solutions to incorporate Prosthetics and Orthotics services into Iranian health benefits package: Using an analytic hierarchy process

“…Therefore, assigning P&O interventions required by the elderly in the HBP may be a proper response to aging in Iran. However, in order to reduce financial burdens on basic health insurances, long-term care insurance can be used, such as those developed in Japan [46].…”

Change in the trend of long-term care service usage following COVID-19 pandemic in Japan: a survey using nationwide statistical summary in 2018-2021

“…The provision system of long-term care (LTC) services, which play a critical role in maintaining the daily lives and functions of elderly individuals [Maruta 2019], was greatly affected by the COVID-19 pandemic, too. In Japan, LTC services are to be provided to individual users according to the needs of daily life by taking into account their physical and cognitive functions [Maruta 2019], so that the gap in utilization of LTC services between before and during pandemic represents at least one part of the above-mentioned decrease in physical activity and social participation by itself. In other words, examining a detailed aspect of the degree and characteristics of change in the use of LTC services will be one of the alternative measures for understanding the impact of the COVID-19 pandemic on the mental and physical health of elderly people.…”