Abstract
BackgroundHome care service demands are increasing in Japan; this necessitates improved service allocation. This study examined the relationship between home visit nursing (HVN) service use and the proportion of elderly people living within 10 min’ travel of HVN agencies.MethodsThe population of elderly people living within reach of HVN agencies for each of 17 municipalities in one low-density prefecture was calculated using public data and geographic information systems.Multilevel logistic analysis for 2641 elderly people was conducted using medical and long-term care insurance claims data from October 2010 to examine the association between the proportion of elderly people reachable by HVNs and service usage in 13 municipalities. Municipality variables included HVN agency allocation appropriateness. Individual variables included HVN usage and demographic variables.ResultsThe reachable proportion of the elderly population ranged from 0.0 to 90.2% in the examined municipalities. The reachable proportion of the elderly population was significantly positively correlated with HVN use (odds ratio: 1.938; confidence interval: 1.265–2.967).ConclusionsResidents living in municipalities with a lower reachable proportion of the elderly population are less likely to use HVN services. Public health interventions should increase the reachable proportion of the elderly population in order to improve HVN service use.
Highlights
Home care service demands are increasing in Japan; this necessitates improved service allocation
In Japan, public health professionals in local municipalities are responsible for improving long-term care systems for disabled elderly [2]
Among the 17 municipalities studied, there were no differences in home visit nursing (HVN) system and insurance coverage
Summary
Home care service demands are increasing in Japan; this necessitates improved service allocation. In Japan, public health professionals in local municipalities are responsible for improving long-term care systems for disabled elderly [2]. The equitable provision of accessible services is among the most important aspects of municipalities’ long-term care system. Public health professions are required to assess and improve regional resources accessible to long-term care services [2]. In Japanese municipalities, long-term care services are concentrated in urban areas due to greater market opportunities [3]. This suggests that availability is lower in rural areas; municipality residents can obtain long-term care services from outside of their municipality. Geographical distribution of resources, as well as resource volume (number of resources relative to the population), must be included in an adequate
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