Abstract
BackgroundPredicting incidence of long-term care insurance (LTCI) certification in the short term is of increasing importance in Japan. The present study examined whether the Kihon Checklist (KCL) can be used to predict incidence of LTCI certification (care level 1 or higher) in the short term among older Japanese persons.MethodsIn 2015, the local government in Tokyo, Japan, distributed the KCL to all individuals older than 65 years who had not been certified as having a disability or who had already been certified as requiring support level 1–2 according to LTCI system. We also collected LTCI certification data within the 3 months after collecting the KCL data. The data of 17,785 respondents were analyzed. First, we selected KCL items strongly associated with incidence of LTCI certification, using stepwise forward-selection multiple logistic regression. Second, we conducted receiver operating characteristic (ROC) analyses for three conditions (1: Selected KCL items, 2: The main 20 KCL items (nos. 1–20), 3: All 25 KCL items). Third, we estimated specificity and sensitivity for each condition.ResultsDuring a 3-month follow-up, 81 (0.5%) individuals required new LTCI certification. Eight KCL items were selected by multiple logistic regression as predictive of certification. The area under the ROC curve in the three conditions was 0.92–0.93, and specificity and sensitivity for all conditions were greater than 80%.ConclusionsThree KCL conditions predicted short-term incidence of LTCI certification. This suggests that KCL items may be used to screen for the risk of incident LTCI certification.
Highlights
Predicting incidence of long-term care insurance (LTCI) certification in the short term is of increasing importance in Japan
receiver operating characteristic (ROC) analysis The Area under the curve (AUC) of the selected eight Kihon Checklist (KCL) items was 0.93, which was the highest of the three conditions (Fig. 1)
The AUCs of the main 20 items and all 25 items were 0.92 and 0.92, respectively
Summary
Predicting incidence of long-term care insurance (LTCI) certification in the short term is of increasing importance in Japan. The present study examined whether the Kihon Checklist (KCL) can be used to predict incidence of LTCI certification (care level 1 or higher) in the short term among older Japanese persons. The long-term care insurance (LTCI) system was introduced in Japan in the year 2000 to support people with disabilities via social security expenses [1]. The KCL is a screening tool developed in Japan for use with older people with frailty [5] It is used by local governments and in community consultations to screen for persons eligible for long-term care prevention programs and to assess the effectiveness of interventions. The KCL consists of 25 items; it requires approximately 15 min for an older person to answer all items [6]
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