Change in long‐term care service usage in Japan following the COVID ‐19 pandemic: A survey using a nationwide statistical summary in 2018–2021

  1. Kenichiro Sato
  2. Yoshiki Niimi
  3. Takeshi Iwatsubo
  4. Shinya Ishii

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Abstract

Social restrictions due to the coronavirus disease (COVID‐19) pandemic forced many long‐term care (LTC) service‐users to refrain from using services. We aimed to evaluate the degree of change in the use of LTC services.

Methods

We retrospectively analyzed data from the publicly distributed nationwide statistics summarizing the monthly number of public LTC insurance users in Japan between April 2018 and March 2021. The degree of decline was quantified as a ratio, where the ratio of a certain month to the reference month was divided by the ratio in the previous year.

Results

The use of LTC services started to decline in March 2020 and reached its largest decline in May 2020. Thereafter, it recovered but insufficiently, even as of late 2020. The degree of decline was particularly large for services provided in facilities for community‐dwelling elderly individuals [Ratio to the previous year = 0.717 (95% CI: 0.645–0.796) in short‐stay services, and Ratio = 0.876 (95% CI: 0.802–0.957) in outpatient services], but was non‐significant in other types of services, including those provided for elderly individuals living in nursing homes.

Conclusions

Community‐dwelling elderly individuals who had used outpatient or short‐stay services were especially affected by the COVID‐19 pandemic in 2020. This underlines the need for further investigation of the medium‐ or long‐term influence of the decline in service usage on the mental and physical health of the LTC service‐users and their caregivers. Geriatr Gerontol Int 2022; 22: 803–809 .

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  1. Version published to 10.1111/ggi.14461
  2. ScreenIT

    SciScore for 10.1101/2021.12.15.21267784: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study includes some limitations. First, the current study is based on the summary statistics across the country, without distinguishing the difference in each prefecture in terms of the baseline service usage or the degree of disruption by the COVID-19 pandemic. So that the degree of decline obtained in this study is more likely to reflect the changes in metropolitan areas with a larger populations such as Tokyo or Osaka, and the changes in prefectures with relatively smaller populations are at risk of being masked. Second, we referred to the monthly count of users in the period from December 2018 to December 2020 in order to quantify the degree of change, this means the serial trend in a much longer level (e.g., 3-5 years or so) cannot be incorporated, leading to a risk of inaccurate estimation in change. Using interrupted time-series analysis (ITSA) may help to this point, although the ITSA may also have some disadvantages in that the emergence of decline was not sudden. And third, it is unclear from this data alone whether the change in users is truly related to the COVID-19 pandemic or whether it is just a pseudo-correlation that was originally caused by another event. Using a nationwide LTC claims database might be of help to examine further detailed changes following the pandemic. Specifically, incorporating difference by municipality is important. In addition to the difference in the baseline populations by prefecture, the difference in the amount of COVID-19 pati...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2021.12.15.21267784v1 on medRxiv