Predictors of continuity in home care for the elderly under public long-term care insurance in Japan

Abstract

With the rapid increase in the elderly population, the number of people requiring care is also increasing and the capacity of the family to provide care is decreasing. Because institutionalization costs are high, more research is needed to investigate predictors of preventing institutionalization. The aim of this study was to examine the impact of social engagement and other predictive factors, including disability, household composition, and formal services, on continuity in home care of the elderly. The study was retrospective longitudinal in design. Data were collected from elderly people living in the community who were certified as eligible for care level 2-5 under Japanese long-term care insurance. Continuity in home care was defined as a participant living at home 1 year after the beginning of the study. Of 244 participants, 200 continued to receive home care (82%). Based on a logistic regression analysis predicting continuity in home care, after controlling for gender, age, initial care level, household composition, and daycare service use, having friends was significantly associated with continuity in home care (odds ratio [OR] 2.42; 95% confidence interval [CI] 1.04-5.65). Participants who lived alone or with a spouse were less likely to continue to receive home care compared with those who lived with others (OR 0.27; 95% CI 0.08-0.87 and OR 0.18; 95% CI 0.06-0.53, respectively). Having friends was a significant predictor of continuity in home care. The promotion of social engagement may be important in preventing institutionalization.