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Background: We investigated how individual home care services by nurses, care workers, and therapists at patients’ homes are related with the continuation of home medical care service provided by medical doctors. Methods: This research retrospectively analyzed primary insured patients registered with the Japanese longterm care insurance system who had newly started using home medical care service, and whose care level was between 1 and 5 according to national long-term care insurance system claims data. We performed multivariable logistic regression analysis to evaluate patients who used home medical care continuously for >3 months and the utilization of each home care service adjusted for patient age, gender, and care level. Results: A total of 26,590 patients were analyzed. Multivariable analysis revealed that the following home care services were associated with longer continuation of home medical care service compared with home medical care alone: day service (OR, 2.10; 95% CI, 1.98-2.23), home help service (1.91; 1.81-2.01), day care including rehabilitation (1.88; 1.69-2.10), home-visit rehabilitation (1.49; 1.31-1.69), and home-visit nursing (1.23; 1.16-1.31). Conclusions : Our results demonstrated a correlation between utilization of home care services and longer continuation of home medical care from the start. These findings may help medical doctors who provide home medical care service collaborate with other home care services by nurses, care workers, and in-home care therapists. 1)東京大学大学院医学系研究科公衆衛生学 2)筑波大学医学医療系ヘルスサービスリサーチ分野 3)早稲田大学政治経済学術院・政治学研究科 4)早稲田大学政治経済学術院 5)福島県立医科大学放射線医学県民健康管理センター 著者連絡先:阿部計大 東京大学大学院医学系研究科公衆衛生学[〒113-8654 東京都文京区本郷 7-3-1 医学部 3号館別棟 4階公衆衛生学 教室] email: kazuhiro_abe_1215@ybb.ne.jp (受付日:2017 年 3 月 4 日,採用日:2017 年 9 月 26 日) C2018 日本プライマリ・ケア連合学会

nihon puraimari, kea rengo gakkaishi/nihon puraimari, kea rengou gakkaishi

The Association between Continuation of Home Medical Care and Utilization of Other Home Care Services for Older People with Long-term Care Insurance in Japan