Tohoku J. Exp. Med., 2015 May, 236(1)

Dialysis Patients' Utilization of Health Care Services Covered by Long-Term Care Insurance in Japan

UTAKO SHIMIZU,¹ YUJI MITADERA,² HAGIKO AOKI¹ and KOUHEI AKAZAWA³

¹School of Health Sciences Faculty of Medicine, Niigata University, Niigata, Niigata, Japan
²Department of Medical Informatics and Statistics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata, Japan
³Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Niigata, Japan

Hemodialysis patients in Japan are aging and thus more patients need support for attending hemodialysis facilities. This study aimed to clarify how dialysis patients utilize the services covered by Japan's public long-term care insurance (LTCI) system. This cross-sectional study was based on LTCI data of March 31, 2009, the latest available data provided by Niigata City, located on the northwest coast of Honshu. Among 30,349 LTCI users in Niigata City, there were 234 dialysis patients. To clarify the characteristics of the dialysis patients, we compared the utilization of LTCI services between the dialysis patients (234 users) and randomly selected 765 non-dialysis users. We also calculated the annual transportation service costs per patient for dialysis patients who continued home care (home care group) and those who switched to long-term hospital care at LTCI care levels 4 and 5 (hospital admission group). These care levels indicate difficulty in walking or maintaining a sitting posture without assistance. The dialysis group more frequently utilized home care and equipment services, such as renting or purchasing care-support products and support for home equipment repair, and utilized facility services and short-stay services (respite care) less frequently (both p < 0.001). Cost per patient was higher in the home care group than in the hospital admission group, because the transportation services for dialysis patients at care levels 4 and 5 involve higher costs. These findings indicate that LTCI services usable for dialysis patients were limited. Therefore, instead of merely subsidizing transportation expenses, transportation services must be improved.

keywords —— care needs; dialysis facilities; dialysis patients; long-term care insurance; transportation service costs

© 2015 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2015, 236, 9-19

Correspondence: Utako Shimizu, School of Health Sciences Faculty of Medicine, Niigata University, 2-746 Asahimachi-dori, Chuo-ku, Niigata, Niigata 951-8518, Japan.

e-mail: shirakaba@clg.niigata-u.ac.jp