Determinants of urgency of nursing home placement

OBJECTS: The aim of this paper was to identify factors affecting the urgency of nursing home placement after introduction of public long-term care insurance. METHODS: The subjects were families including at least one disabled elderly person and one another family member in two cities in Chugoku Prefecture. The measure of the urgency of placement was 0 if the family did not submit any application for placement, 1 if the care managers judged that the elderly person should enter in the future when she/he really needs placement, 2 if the care managers judged that she/he might be able to wait for a short while, and 3 if the care managers judged that she/he should enter as early as possible. Our estimation method was by ordered logit model. The dependent variable was the measure of the urgency and the independent variables were several attributes of the families. In the estimation, we considered the possibility that the coefficients depend on categories of dependent variable. RESULTS: We obtained data for 146 waiting families and 494 others (total 640). There were differences in the urgency of placement among waiting elderly as follows "she/he should enter as early as possible" (28.8%); "she/he can wait for a while" (32.2%), "she/he should enter in the future when she/he really needs placement" (39.0%). The results of multivariate analyses showed that the urgency of placement correlated significantly with the severity of the elderly persons disabilities, the number of primary caregivers' self-symptoms, the family members' negative attitude toward caregiving, residing in city A, not having one's own house and limited use of short-stay facilities due to the circumstances of the providers. CONCLUSION: When judging the urgency of placement, we should consider not only whether the applicant has submitted a request for a nursing home or not, but also differences among the waiting families. The urgency of placement correlates significantly with severity of disability of the elderly person, the number of primary caregivers' self-symptoms, the family members' negative attitude for caregiving, residing in city A, not having one's own house, and limited use of short-stay facilities due to the circumstances of the providers.