在日本的公共长期护理保险系统中,功能依赖的预防服务的技术效率:生态研究
Ayumi Hashimoto1, Hideki Hashimoto2, Hiroyuki Kawaguchi3
1Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
International journal of health policy and management
|August 5, 2024
概括
日本的公共长期护理保险系统通过预防服务有效地减少了功能依赖的风险. 分散的,基于协议的分娩对老年人来说是有效的.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 公共长期护理保险 (LTCI) 系统旨在提供公平的机会,但由于人口老龄化而面临金融可持续性挑战.
- 日本的LTCI系统实施了基于家庭和社区的预防服务 (2006-2015年),以管理老年人对功能依赖的需求.
- 之前对这些预防服务的评估,对其有效性产生了不确定的结果.
研究的目的:
- 评估日本公共LTCI系统内的当地预防服务的边际收益和技术效率.
- 确定特定预防服务对降低老年人群中适度功能依赖的风险的影响.
主要方法:
- 利用了来自474家日本地方公共保险公司的2009-2014年面板数据.
- 采用随机边界分析来估计边际收益和技术效率.
- 结果指标是转换的性别和年龄调整的观察到的与预期的65岁以上的中等护理认证个体的比例.
主要成果:
- 除了功能查之外,预防服务显著降低了中度功能依赖的风险.
- 成人日托,其他护理和家庭护理的1%增加与平均结果变化分别为0.13%,0.07%和0.04%有关.
- 当地公共保险公司的技术效率中位数高达0.94 (IQR:0.89-0.99).
结论:
- 以人口为基础的预防服务,根据标准化协议分散提供,可以在各地区实现有效的风险降低.
- 调查结果支持将预防性好处纳入公共LTCI系统作为可行的战略.
- 这项研究为优化长期护理保险计划的福利覆盖提供了见解.
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