Modelling life history in advanced-aged period by care-cycle and creating multi-state life table

Modelling life history in advanced-aged period by care-cycle and creating multi-state life table


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Speaker(s): Shuji Tanaka (Nihon University)

In recent years, as tightness of social security resources has become a real problem, it is required to solve the difficult problem of achieving efficiency of medical and nursing care expenditure without lowering health level. For this purpose, it is indispensable to conduct a comprehensive study of the occurrence mechanism of medical and nursing care events. Hasegawa's idea on care cycle theory (2013) has opened up the possibility to realize the effect of two birds with one stone by appropriately interposing by catching the pattern of the transition of nursing care and medical condition. However, it has been impossible to conduct empirical research to verify the effectiveness of this theory from the difficulty of obtaining data.

Recently, however, we had an opportunity to obtain a sample LTCI (Long-term care insurance) participants data of a certain city in Kansai district, so that it was possible to trace the course of medical care / nursing care up to death and apply Markov process model and construct multi-state life table. In Japan, medical and nursing care services that can be said as both wheels of the public social security system are provided for health maintenance in elderly, but from the viewpoint of maintaining the lifelong life quality in individual life history. For this reason, it is not clear what combination of medical and nursing care services are most effective for various needs of the elderly.

In this research, based on the care cycle theory which integrates medical and nursing care events, we developed a method to grasp older health condition as life history and analyze it as stochastic process and its model to explore a new application field for public health.

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