Table 4.
Adjusted hazard ratios (HR) and 95% confidence interval (CI) for admission to hospital or long-term care institution or death (N = 565)
| Analysis 1: The overall effect of home and community-based services | Analysis 2: The effects of each type of home and community-based service | ||||||
|---|---|---|---|---|---|---|---|
| Adjusted HR | 95% CI | p-value | Adjusted HR | 95% CI | p-value | ||
| Sex | 0.007 | Sex | 0.006 | ||||
| Male | 1 | Male | 1 | ||||
| Female | 0.749 | 0.607-0.924 | Female | 0.742 | 0.600-0.917 | ||
| Age*1 | 0.003 | Age*1 | 0.001 | ||||
| < 75 | 1 | < 75 | 1 | ||||
| 75 - 80 | 1.237 | 0.893-1.713 | 0.201 | 75-80 | 1.231 | 0.884-1.715 | 0.219 |
| 80 - 85 | 1.406 | 1.023-1.934 | 0.036 | 80 - 85 | 1.436 | 1.035-1.991 | 0.030 |
| 85 - 90 | 1.435 | 1.041-1.979 | 0.027 | 85-90 | 1.526 | 1.103-2.111 | 0.011 |
| ≧ 90 | 2.168 | 1.464-3.212 | 0.000 | ≧ 90 | 2.261 | 1.514-3.378 | 0.000 |
| Eligibility level*1 | 0.014 | Eligibility level*1 | 0.000 | ||||
| Support level*2 | 1 | Support level*2 | 1 | ||||
| Care level 1·2*3 | 1.177 | 0.946-1.465 | 0.143 | Care level 1·2*3 | 1.314 | 1.057-1.634 | 0.014 |
| Care level 3·4·5 | 1.769 | 1.199-2.611 | 0.004 | Care level 3·4·5 | 2.154 | 1.450-3.199 | 0.000 |
| Living area*1 | 0.047 | Living area*1 | 0.045 | ||||
| Town A | 1 | Town A | 1 | ||||
| Town B | 0.804 | 0.648-0.997 | Town B | 0.801 | 0.645-0.995 | ||
| Year of the first certification | 0.946 | 0.902-0.992 | 0.022 | Year of the first certification | 0.942 | 0.900-0.986 | 0.011 |
| Income level for determining premiums*1 | Not Selected | Income level for determining premiums*1 | Not Selected | ||||
| Average monthly outpatient medical expenditures (yen) | 0.000 | Average monthly outpatient medical expenditures (yen) | 0.000 | ||||
| Low: 0 - 24,000 | 1 | Low: 0 - 24,000 | 1 | ||||
| Middle: 24,000 - 53,000 | 1.226 | 0.947-1.587 | 0.122 | Middle: 24,000 - 53,000 | 1.191 | 0.920-1.542 | 0.185 |
| High: ≧ 53,000 | 2.138 | 1.663-2.749 | 0.000 | High: ≧ 53,000 | 2.149 | 1.668-2.769 | 0.000 |
| Average monthly total home and community-based services expenditures*4 | (yen) | 0.005 | Day care*5 | 0.088 | |||
| 0 | 1 | Not use | 1 | ||||
| Low: 189 - 18,000 | 0.700 | 0.526-0.931 | 0.014 | Use | 0.821 | 0.655-1.029 | |
| Middle: 18,000 - 36,000 | 0.587 | 0.436-0.791 | 0.000 | Respite care*6 | 0.013 | ||
| High: ≧36,000 | 0.722 | 0.542-0.960 | 0.025 | Not use | 1 | ||
| Akaike' s Information Criteria(AIC) = 4434.401 | Use | 0.714 | 0.547-0.931 | ||||
| Rental services for assistive devices*7 | 0.011 | ||||||
| Not use | 1 | ||||||
| Use | 0.703 | 0.537-0.921 | |||||
| Home-help*8 | Not Selected | ||||||
| Visiting nurse*7 | Not Selected | ||||||
| Management & guidance*7 | Not Selected | ||||||
| Day rehabilitation*7 | Not Selected | ||||||
| AIC = 4423.682 | |||||||
Outcome variable was the number of months from the first certification of being eligible for long-term care insurance benefits until hospitalisation, institutionalisation, death or censoring in both Analysis 1 and 2. All years are fiscal years; April to March.
*1 Data when the insured individuals are certified being eligible for long-term care insurance benefits for the first time.
*2 After 2006, Support level means Support level 1.
*3 After 2006, Care level 1 includes Support level 2.
*4 Consists of expenditures of Home-help, Home-visit bathing, Visiting nurse, Management & guidance, Day care, Day rehabilitation, Respite care and Rental services for assistive devices.
*5 After 2006, "Preventive care" and "Services for the elderly with dementia" are included.
*6 Consists of regular and medically related Respite care. After 2006, "Preventive care" is included.
*7 After 2006, "Preventive care" is included.
*8 Includes Home-visit bathing service. After 2006, "Preventive care" and "Night care" are included.