[Changes in long-term care certification rate and related factors in municipalities affected by the heavy rain disaster in July 2018].

ABSTRACT

Objectives　The purpose of this study was to determine the change in the certification rate for long-term care (LTC) in the municipalities affected by the heavy rain disaster in July 2018, and to clarify the relationships between the change in the LTC certification rate and the damage situation and regional characteristics.Methods　The subjects were 108 municipalities to which the Disaster Relief Act was applied. Interrupted time series analyses were conducted of the monthly LTC certification rate for a total of 37 months from July 2016 to July 2019, and the changes in the LTC, mild LTC (requiring support 1 and 2), moderate LTC (requiring long-term care 1 to 3), and severe LTC (requiring long-term care 4 and 5) certification rates after the disaster were determined. Multinomial logistic regression analyses were performed to clarify the relationship between trends of changes in the LTC certification rate after the disaster, the damage situation (number of damaged houses, number of dead and missing), and the regional characteristics (population rate of people aged 65 and over, population density, taxable income, population per public health nurse, capacity of long-term care insurance facilities, number of hospital beds, number of clinics, specific health examination implementation rate, and specific health guidance implementation rate).Results　The LTC and mild LTC certification rates showed significant increases in the month of the disaster and changes in trends after the disaster. The change in the post-disaster trend of the moderate LTC certification rate was significantly lower. The severe LTC certification rate showed a significant increase only in the month of the disaster; however, there was no significant change seen in the post-disaster trend. The downward change in the trend of the moderate LTC certification rate was negatively related to the population rate of people aged 65 and over, and positively related to the number of clinics. No significant associations of the LTC, mild LTC, and severe LTC certification rates with any of the variables related to the disaster situation and regional characteristics were found.Conclusion　The results of this study suggest that the demand for long-term care insurance services may increase as a result of disasters experienced by elderly requiring mild LTC certification who have a relatively high degree of independence.