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Table 1 Features of five types of home-visit nursing agencies in Japan categorized by cluster analysis from three nationwide surveys
| Total | Nurse centered | Rihabilitation centered | Psychiatric centered | Urban centered | Rural centered | |
|---|---|---|---|---|---|---|
| n = 5,161 (100.0%) | n = 560 (10.9%) | n = 211 (4.1%) | n = 360 (7.0%) | n = 1,784 (34.5%) | n = 2,246 (43.5%) | |
| A) Operating structure | ||||||
| Main body of establishment | ||||||
| Hospital corporation (a) | 39% | 30% | 26% | 43% | 38% | 43% |
| Medical association (a) | 5% | 10% | 0% | 2% | 6% | 4% |
| Nursing association (a) | 3% | 8% | 0% | 2% | 3% | 2% |
| Incorporated association/general incorporated foundation (a) | 6% | 11% | 1% | 6% | 6% | 4% |
| Social welfare corporation (a) | 7% | 7% | 6% | 7% | 7% | 8% |
| Business corporation (a) | 27% | 17% | 64% | 31% | 27% | 26% |
| Others (a) | 13% | 17% | 2% | 11% | 14% | 13% |
| Operating years (average) | ||||||
| Operating years (b) | 10.9 | 12.8 | 9.3 | 10.4 | 11.2 | 10.4 |
| Parallel establishment of medical facility | ||||||
| Clinics with no beds (c) | 13% | 13% | 13% | 5% | 13% | 13% |
| Clinics with beds (c) | 4% | 1% | 2% | 4% | 4% | 5% |
| Hospitals (c) | 37% | 39% | 23% | 58% | 35% | 37% |
| None/missing value (c) | 47% | 49% | 64% | 34% | 49% | 46% |
| Care management agency and branch agency | ||||||
| Parallel establishment of care management agency (a) | 54% | 64% | 41% | 38% | 57% | 53% |
| Another post of a worker as care manager (a) | 18% | 32% | 8% | 11% | 21% | 15% |
| Establishment of branch agency (a) | 4% | 10% | 9% | 2% | 3% | 2% |
| B) Management of service | ||||||
| Operation days | ||||||
| Only weekdays (b) | 44% | 47% | 55% | 40% | 44% | 42% |
| Weekdays and Saturdays (b) | 47% | 43% | 35% | 53% | 46% | 48% |
| Weekdays, Saturdays, and Sundays (b) | 10% | 10% | 10% | 7% | 10% | 10% |
| Status of notification system | ||||||
| Addition of emergency services delivery (a) | 86% | 98% | 62% | 68% | 90% | 84% |
| Addition of 24-hour service delivery (a) | 77% | 97% | 53% | 55% | 83% | 72% |
| Addition of intensive medical management (a) | 92% | 100% | 77% | 66% | 97% | 91% |
| Addition of end-of-life care (a) | 85% | 98% | 61% | 59% | 90% | 83% |
| Home-visit nursing care in private nursing homes | ||||||
| Provisions of home-visit nursing services for patients in private nursing homes (c) | 6% | 7% | 8% | 11% | 5% | 6% |
| C) Employment | ||||||
| Number of workers (average) | ||||||
| Nurses - converted as full-time workers (a) | 4.7 | 8.8 | 5.1 | 4.4 | 4.2 | 4 |
| Rehabilitation staff - converted as full-time workers (a) | 0.9 | 1.1 | 8.3 | 0.4 | 0.6 | 0.5 |
| Ratio of rehabilitation staff to total workers (a) | 23% | 0% | 83% | 1% | 3% | 2% |
| D) Patient utilization | ||||||
| Patients (average) | ||||||
| Number of patients (a) | 65.9 | 113.8 | 184 | 58.4 | 73 | 38.4 |
| Facilities with patients using medical insurance who accounted for 50% or more (a) | 7% | 4% | 2% | 90% | 1% | 0% |
| Cancer at terminal stage (c) | 2.6 | 5.8 | 2.3 | 1.3 | 2.6 | 1.9 |
| Intractable disease (c) | 6.7 | 11.1 | 21.1 | 5.1 | 6.5 | 4.4 |
| Psychiatric disease (c) | 5.2 | 4.8 | 2.2 | 50.7 | 2.7 | 1.7 |
| Number of patients and home visits per worker (average) | ||||||
| Patients per worker (a) | 11.6 | 11.9 | 13.9 | 12.1 | 15.4 | 8.3 |
| Patients of terminal-stage cancer care per worker (c) | 0.5 | 0.6 | 0.2 | 0.2 | 0.5 | 0.4 |
| Patients with intractable diseases per worker (c) | 1.1 | 1.1 | 1.5 | 1 | 1.3 | 0.9 |
| Patients with psychiatric diseases per worker (c) | 1 | 0.4 | 0.2 | 9.7 | 0.6 | 0.4 |
| Pediatric patients per worker (c) | 0.2 | 0.2 | 0.3 | 0.4 | 0.2 | 0.1 |
| Home visits per worker (a) | 64.4 | 68.8 | 72.5 | 61.3 | 85.1 | 46.6 |
| System to accept patients | ||||||
| Home intravenous alimentation (b) | 83% | 98% | 75% | 56% | 89% | 78% |
| Mechanical ventilation (b) | 72% | 91% | 77% | 49% | 77% | 64% |
| Pain control with narcotic medication (b) | 84% | 97% | 69% | 55% | 90% | 80% |
| Number of patient deaths per year (average) | ||||||
| Total number of patient deaths (c) | 13.9 | 32.4 | 13.1 | 5.4 | 14.5 | 9.2 |
| Number of patient deaths at home (c) | 7.8 | 19.6 | 7 | 3.2 | 7.9 | 4.8 |
| Number of patient deaths at a place other than home (c) | 6.1 | 12.8 | 6.2 | 2.2 | 6.6 | 4.3 |
| Rate of deaths at home (c) | 62% | 65% | 59% | 69% | 62% | 60% |
| Ratios related to death from cancer (average) | ||||||
| Number of patients who died from cancer (c) | 8.5 | 19 | 6.3 | 3.7 | 8.5 | 6.2 |
| Ratio of cancer patients among patients who died (c) | 45% | 47% | 30% | 38% | 44% | 47% |
| Ratio of deaths at home of patients who died from cancer (c) | 54% | 59% | 50% | 52% | 56% | 51% |
| Ratio of deaths at home of patients who died due to a cause other than cancer (c) | 46% | 49% | 37% | 53% | 47% | 46% |
| E) Financial condition | ||||||
| Financial performance of agency | ||||||
| Profitable (c) | 44% | 62% | 58% | 35% | 49% | 34% |
| Balanced (c) | 27% | 19% | 26% | 22% | 31% | 27% |
| Unprofitable (c) | 20% | 14% | 3% | 25% | 14% | 28% |
| Unclear (c) | 9% | 6% | 14% | 18% | 6% | 11% |
| F) Regional cooperation | ||||||
| Characteristics of location of the facility (cities, towns and villages) | ||||||
| Population density median (b) | 1122/km2 | 1234/km2 | 3538/km2 | 1157/km2 | 1992/km2 | 808/km2 |
| Population aging rate average (b) | 23.4 | 22.8 | 22.2 | 22.5 | 23.1 | 24 |
| Directions and cooperation (average) | ||||||
| Collaborative hospitals who received directions (b) | 23 | 34 | 53 | 16 | 26 | 17 |
| Collaborative physicians who received directions (b) | 34.2 | 52.9 | 75.8 | 25.7 | 38.4 | 24 |
| Collaborative care management agencies | 18 | 25 | 39 | 12 | 20 | 13 |
