Kazuhiro Abe1,2, Yuta Taniguchi3, Ichiro Kawachi4, Taeko Watanabe5, Nanako Tamiya5,6. 1. Takemi Program in International Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA. 2. Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 3. Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan. 4. Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA. 5. Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan. 6. Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
Abstract
AIM: The study assessed the association between boosting the workforce supply by types of long-term care services and in-home deaths among older people at the municipality level. METHODS: A fixed-effect panel data analysis was conducted using administrative data for every 3 years from 2008 to 2014. The outcome was the proportion of home deaths, excluding those due to external factors, such as suicide or accident. The explanatory variables were the full-time equivalent numbers of care workers engaged in in-home services, day services, short-stay services, and long-term care facilities per 1000 population aged 65 years and older. Ordinary least squares estimation was conducted, with standard errors corrected for clustering at the prefecture level, adjusting the covariates. RESULTS: Analysis included 1706 municipalities. One care worker increase providing day services per 1000 population aged 65 years and older was associated with a 0.09% increase in the proportion of deaths at home (95% CI: 0.008-0.17). Although statistically non-significant, the number of care workers providing in-home services was positively associated with the proportion of home deaths, whereas the number of those providing short-stay services and providing long-term care facilities and nursing home services were inversely associated with home deaths. CONCLUSIONS: Given the increased number of care-dependent older people who opt to stay at home until death, and their informal caregivers who have the burden and stress of care, the findings suggest that policymakers should ensure that the number of care workers for day services is sufficient for supporting care recipients and informal caregivers. Geriatr Gerontol Int 2021; 21: 712-717.
AIM: The study assessed the association between boosting the workforce supply by types of long-term care services and in-home deaths among older people at the municipality level. METHODS: A fixed-effect panel data analysis was conducted using administrative data for every 3 years from 2008 to 2014. The outcome was the proportion of home deaths, excluding those due to external factors, such as suicide or accident. The explanatory variables were the full-time equivalent numbers of care workers engaged in in-home services, day services, short-stay services, and long-term care facilities per 1000 population aged 65 years and older. Ordinary least squares estimation was conducted, with standard errors corrected for clustering at the prefecture level, adjusting the covariates. RESULTS: Analysis included 1706 municipalities. One care worker increase providing day services per 1000 population aged 65 years and older was associated with a 0.09% increase in the proportion of deaths at home (95% CI: 0.008-0.17). Although statistically non-significant, the number of care workers providing in-home services was positively associated with the proportion of home deaths, whereas the number of those providing short-stay services and providing long-term care facilities and nursing home services were inversely associated with home deaths. CONCLUSIONS: Given the increased number of care-dependent older people who opt to stay at home until death, and their informal caregivers who have the burden and stress of care, the findings suggest that policymakers should ensure that the number of care workers for day services is sufficient for supporting care recipients and informal caregivers. Geriatr Gerontol Int 2021; 21: 712-717.