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Table 4 Adjusted hazard ratio (HR) and 95% confidence interval (CI) for admission to hospital or long-term care institution or death (N = 565)

From: Impact of home and community-based services on hospitalisation and institutionalisation among individuals eligible for long-term care insurance in Japan

Analysis 1: The overall effect of home and community-based services

Analysis 2: The effects of each type of home and community-based service

 

Adjusted HR

95% CI

p-value

 

Adjusted HR

95% CI

p-value

Sex

  

0.007

Sex

  

0.006

   Male

1

  

   Male

1

  

   Female

0.749

0.607-0.924

 

   Female

0.742

0.600-0.917

 

Age* 1

  

0.003

Age* 1

  

0.001

   < 75

1

  

   < 75

1

  

   75 - 80

1.237

0.893-1.713

0.201

   75 - 80

1.231

0.884-1.715

0.219

   80 - 85

1.406

1.023-1.934

0.036

   80 - 85

1.436

1.035-1.991

0.030

   85 - 90

1.435

1.041-1.979

0.027

   85 - 90

1.526

1.103-2.111

0.011

   ≧ 90

2.168

1.464-3.212

0.000

   ≧ 90

2.261

1.514-3.378

0.000

Eligibility level* 1

  

0.014

Eligibility level* 1

  

0.000

   Support level*2

1

  

   Support level*2

1

  

   Care level 1·2*3

1.177

0.946-1.465

0.143

   Care level 1·2*3

1.314

1.057-1.634

0.014

   Care level 3·4·5

1.769

1.199-2.611

0.004

   Care level 3·4·5

2.154

1.450-3.199

0.000

Living area* 1

  

0.047

Living area* 1

  

0.045

   Town A

1

  

   Town A

1

  

   Town B

0.804

0.648-0.997

 

   Town B

0.801

0.645-0.995

 

Year of the first certification

0.946

0.902-0.992

0.022

Year of the first certification

0.942

0.900-0.986

0.011

Income level for determining premiums* 1

 

Not Selected

 

Income level for determining premiums* 1

 

Not Selected

 

Average monthly outpatient medical expenditures (yen)

  

0.000

Average monthly outpatient medical expenditures (yen)

  

0.000

   Low: 0 - 24,000

1

  

   Low: 0 - 24,000

1

  

   Middle: 24,000 - 53,000

1.226

0.947-1.587

0.122

   Middle: 24,000 - 53,000

1.191

0.920-1.542

0.185

   High: ≧ 53,000

2.138

1.663-2.749

0.000

   High: ≧ 53,000

2.149

1.668-2.769

0.000

Average monthly total home and community-based services expenditures (yen)* 4

  

0.005

Day care* 5

  

0.088

   0

1

  

   Not use

1

  

   Low: 189 - 18,000

0.700

0.526-0.931

0.014

   Use

0.821

0.655-1.029

 

   Middle: 18,000 - 36,000

0.587

0.436-0.791

0.000

Respite care* 6

  

0.013

   High: ≧ 36,000

0.722

0.542-0.960

0.025

   Not use

1

  
 

Akaike' s Information Criteria(AIC) = 4434.401

   Use

0.714

0.547-0.931

 
    

Rental services for assistive devices* 7

 

0.011

    

   Not use

1

  
    

   Use

0.703

0.537-0.921

 
    

Home-help* 8

 

Not Selected

 
    

Visiting nurse* 7

 

Not Selected

 
    

Management & guidance* 7

 

Not Selected

 
    

Day rehabilitation* 7

 

Not Selected

 
     

AIC = 4423.682

  1. Outcome variable was the number of months from the first certification of being eligible for long-term care insurance benefits until hospitalisation, institutionalisation, death or censoring in both Analysis 1 and 2. All years are fiscal years; April to March.
  2. *1 Data when the insured individuals are certified being eligible for long-term care insurance benefits for the first time.
  3. *2 After 2006, Support level means Support level 1.
  4. *3 After 2006, Care level 1 includes Support level 2.
  5. *4 Consists of expenditures of Home-help, Home-visit bathing, Visiting nurse, Management & guidance, Day care, Day rehabilitation, Respite care and Rental services for assistive devices.
  6. *5 After 2006, "Preventive care" and "Services for the elderly with dementia" are included.
  7. *6 Consists of regular and medically-related Respite care. After 2006, "Preventive care" is included.
  8. *7 After 2006, "Preventive care" is included.
  9. *8 Includes Home-visit bathing service. After 2006, "Preventive care" and "Night care" are included.