Increased care-need in older long-term care insurance users after the 2018 Japan Floods: a retrospective cohort study based on the Japanese long-term care insurance claims

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Abstract

Background

Level of care-need (LOC) is an indicator of elderly person’s disability level and is officially used to determine the care services provided in Japan’s long-term care insurance (LTCI) system. The 2018 Japan Floods, which struck western Japan in July 2018, were the country’s second largest water disaster. This study determined the extent to which the disaster affected the LOC of victims and compared it with that of non-victims.

Methods

This is a retrospective cohort study, based on the Japanese long-term care insurance claims from two months before (May 2018) to five months after the disaster (December 2018) in Hiroshima, Okayama, and Ehime prefectures, which were the most severely damaged areas in the country. A code indicating victim status, certified by a residential municipality, was used to distinguish between victims and non-victims. Those aged 64 years or younger, those who had the most severe LOC before the disaster, and those whose LOC increased even before the disaster were excluded. The primary endpoint was the augmentation of pre-disaster LOC after the disaster, which was evaluated using the survival time analysis. Age, gender, and type of care service were used as covariates.

Results

Of the total 193,723 participants, 1,407 (0.7%) were certified disaster victims. Five months after the disaster, 135 (9.6%) of victims and 14,817 (7.7%) of non-victims experienced the rise of LOC. The victim group was significantly more likely to experience an augmentation of LOC than the non-victim group (adjusted hazard ratio 1.24; 95% confidence interval 1.06–1.45).

Conclusions

Older people who were affected by the disaster needed more care than before and the degree of care-need increase was substantially more than non-victims. The result suggests that natural disasters generate more demand for care services among the older people, and incur more resources and cost for society than before.

Supplementary information

The online version contains supplementary material available at https://doi.org/10.1265/ehpm.22-00269.

Related collections

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Author and article information

Contributors

Kotaro Ikeda:

ORCID: http://orcid.org/0000-0002-8099-9074

koikeda@hiroshima-u.ac.jp

Journal

Journal ID (nlm-ta): Environ Health Prev Med

Journal ID (iso-abbrev): Environ Health Prev Med

Journal ID (publisher-id): EHPM

Title: Environmental Health and Preventive Medicine

Publisher: Japanese Society for Hygiene

ISSN (Print): 1342-078X

ISSN (Electronic): 1347-4715

Publication date (Electronic, pub): 17 May 2023

Publication date (Electronic, collection): 2023

Volume: 28

Electronic Location Identifier: 31

Affiliations

[1 ]Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan

[2 ]Department of Community-Based Medical System, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

[3 ]Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan

[4 ]Environmental Health Sciences Laboratory, Graduate School of Advanced Science and Engineering, Hiroshima University, Hiroshima, Japan

[5 ]Center for the Planetary Health and Innovation Science, The IDEC Institute, Hiroshima University, Hiroshima, Japan

[6 ]Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

[7 ]Division of Health Policy and Management, Center for Community Medicine, Jichi Medical University, Tochigi, Japan

Author information

Kotaro Ikeda http://orcid.org/0000-0002-8099-9074

Article

Publisher ID: 22-00269 Other ID: ehpm-28-031

DOI: 10.1265/ehpm.22-00269

PMC ID: 10233335

PubMed ID: 37197943

SO-VID: 47e33f20-7c70-4c43-998a-bac60bfc733f

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 14 November 2022

Date accepted : 2 April 2023

Page count

Pages: 9

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