Abstract

PurposeIn developed countries, progressive rapid aging is increasing the need for social care. This study aimed to determine Japanese utility weights for the Adult Social Care Outcomes Toolkit (ASCOT) four-level self-completion questionnaire (SCT4).MethodsWe recruited 1050 Japanese respondents from the general population, stratified by sex and age, from five major cities. In the best–worst scaling (BWS) phase, respondents ranked various social care-related quality of life (SCRQoL) states as “best,” “worst,” “second-best,” or “second-worst,” as per the ASCOT. Then, respondents were asked to evaluate eight different SCRQOL states by composite time-trade off (cTTO). A mixed logit model was used to analyze BWS data. The association between cTTO and latent BWS scores was used to estimate a scoring formula that would convert BWS scores to SC-QALY (social care quality-adjusted life year) scores.ResultsJapanese BWS weightings for ASCOT-SCT4 were successfully estimated and found generally consistent with the UK utility weights. However, coefficients on level 3 of “Control over daily life” and “Occupation” domains differed markedly between Japan and the UK. The worst Japanese SCRQoL state was lower than that for the UK, as Japanese cTTO results showed more negative valuations. In general, Japanese SC-QALY score (for more than 90% of health states) was lower than that for the UK.ConclusionsWe successfully obtained Japanese utility weights for ASCOT SCT4. This will contribute to the measurement and understanding of social care outcomes.

Highlights

  • Many developed countries are facing rapid population aging, with Japan being one of the world’s fastest-aging countries

  • We developed a Japanese version of the Adult Social Care Outcomes Toolkit (ASCOT) four-level selfcompletion questionnaire (SCT4) in 2017, with subsequent linguistic validation [9]

  • The ASCOT-SCT4 consists of eight domains, covering the following aspects of social care-related quality of life (SCRQoL): control over daily life, personal cleanliness and comfort, food and drink, personal safety, social participation and involvement, occupation, accommodation cleanliness and comfort, and dignity

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Summary

Introduction

Many developed countries are facing rapid population aging, with Japan being one of the world’s fastest-aging countries. The proportion of elderly people (aged 65 and above) in 2016 was 27.3% in Japan [1], 23% in Italy, and 21% in Germany, Portugal, and Finland [2]. Rapid aging will give rise to issues pertaining to financial and social sustainability in Japan. This situation is not limited to Japan; given the speed of population aging, other countries, including Asian countries such as China, South Korea, and Thailand, will face similar issues in the future

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