Analysis of Causes of Dependency Under the Long Term Care Insurance Scheme in Japan

After the introduction of the Long Term Care Insurance (LTCI), the number of persons who received the LTCI services increased very rapidly. This causes a rapid increase in LTCI expenditures and premium. In order to make LTCI scheme sustainable, it is pivotal how to maintain the ADL and health level of the elderly. For this purpose, we have investigated the causes of dependency among the LTCI users in order to establish an appropriate preventive strategy. The materials were LTCI related data (assessment sheet and physician’s opinion report) of 2002 whole year of K city, Fukuoka. Total number of data is 30,562 cases. The cases were stratified by diagnosis, LTCI eligibility level, and type of residence. There are interesting differences in causal diagnoses according to the eligibility level. In the case of slightly frail elderly, the osteo-muscular disorders are the most important causes of dependency. On the contrary, among the severely frail elderly, the cerebro-vascular diseases (CVD) were the most important. The number of users with dementia increases along with LTCI level. Considering that the largest increase in LTCI users has been observed in the slightly frail elderly, it is very important to organize a ADL prevention program focusing to osteo-muscular disorders, such as a community based physical fitness class.