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[Evaluation of indices indicating elderly long-term care need in municipalities].

OBJECTIVE
To establish a way to evaluate preventive care programs using indices that indicate the status of long-term care need for elderly in municipalities.


METHOD
Based on the number of people certified as subject to long-term care need and the number of deaths in Taihaku Ward in Sendai City, 3 indices in 14 junior high school districts in the ward were derived; Healthy Life Expectancy for 65 year old men and women (the period in which certification for long-term care need is not made), Hours of Care Need (age-adjusted standard hours for care need) and the Odds Ratio (age-adjusted relative risk) for the elderly aged 65 years or older. Yearly comparisons of the indices were made for 2000 vs 2001, 2001 vs 2002 and 2000 vs 2002. The relationships between the three indices were further analyzed for 2000, 2001 and 2002. Care Compensation by district (age-adjusted care compensation by district was derived for 2001) and its relationships to Healthy Life Expectancy, Hours of Care Need and the Odds Ratio were analyzed by school district for 2001.


RESULTS
1) The Hours of Care Need by district significantly correlated with the Odds Ratios by district for 2000, 2001 and 2002. Both the Hours of Care Need and the Odds Ratio by district also significantly correlated between 2000 and 2001, between 2001 and 2002 and between 2000 and 2002. Healthy Life Expectancy did not show a significant correlation between 2000 and 2001, between 2001 and 2002 and between 2000 and 2002, for men and women. 2) The 2001 Care Compensation by district was obviously proportional to both Hours of Care Need by district and the Odds Ratio by district but did not correlate with Healthy Life Expectancy by district for men and women. 3) Using the co-relationship of the Hours of Care Need between the years, the percentage of applications for certification for care need by people needing care was estimated at 65% for 2000, 87.5% for 2001 and 101% for 2002. This implies that in 2002 almost all the people who needed care applied for the certification. The 2001 Odds Ratio by district was significantly low in district D and significantly high in district H.


CONCLUSIONS
Hours of Care Need correlate well with the Odds Ratio and also with Care Compensation which represents long-term care insurance service expenses. The results clearly indicate that the 3 indices represent the status of care need of the elderly in these districts, even with conservative estimates, after 2002. It is suggested that Hours of Care Need and the Odds Ratio are appropriate as indices to evaluate preventive care programs in municipalities.