著者
Sho Nishiguchi Nagisa Sugaya Kentaro Sakamaki Shunsaku Mizushima
出版者
International Research and Cooperation Association for Bio & Socio-Sciences Advancement
雑誌
BioScience Trends (ISSN:18817815)
巻号頁・発行日
vol.11, no.1, pp.54-61, 2017-02-28 (Released:2017-03-22)
参考文献数
39
被引用文献数
2 3

The end-of-life (EOL) care bonus introduced by the Japanese government works as a financial incentive and framework of quality preservation, including advance care planning, for EOL care among nursing home residents. This study aims to clarify the effects of the EOL care bonus in promoting EOL care in nursing homes. A longitudinal observational study using a questionnaire was conducted. We invited 378 nursing homes in Kanagawa prefecture in Japan, a region with a rapidly aging population, to participate in the study. The outcome was the number of residents dying in nursing homes from 2004 to 2014. In a linear mixed model, fixed-effect factors included year established, unit care, regional elderly population rate and hospital beds, adjacent affiliated hospital, full-time physician on site, physician's support during off-time, basic EOL care policy, usage of the EOL care bonus, EOL care conference, and staff experience of EOL care. A total of 237 nursing home facilities responded (62.7%). The linear mixed model showed that the availability of the EOL care bonus (coefficient 3.1, 95 % CI 0.67-5.51, p = 0.012) and years of usage of the EOL care bonus (p < 0.001) were significantly associated with increased numbers of residents dying in nursing homes. Our analysis revealed that the EOL care bonus has the potential to increase the number of residents receiving EOL care in nursing homes over several years. EOL care conferences, physician support for emergency care during off-time, and the presence of an adjacent affiliated hospital may also increase the number of residents receiving EOL care in nursing homes. These results suggest that a government financial incentive may contribute to effective EOL care among nursing home residents in other developed countries with rapidly aging populations.

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医師は医学以外のこと苦手かもしれない。高齢者施設についてよく分からない。高齢者施設での看取りは増えていて、特別養護老人ホームでの看取り介護も同様に増加している。 #高齢者施設 #特別養護老人ホーム #看取り介護 https://t.co/Z5cpq0qIEW
"End-of-life care bonus promoting end-of-life care in nursing homes" #hpm #EOL https://t.co/Zdjctzizfs

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