Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey

Objective The purpose of this study was to clarify the microlevel determinants of the economic burden of dementia care at home in Japanese community settings by classifying them into subgroups of factors related to people with dementia and their caregivers.Design A cross-sectional online survey.Part...

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Main Authors: Noriko Sasaki, Yuichi Imanaka, Takayo Nakabe, Hironori Uematsu, Susumu Kunisawa, Anders Wimo
Format: Article
Language:English
Published: BMJ Publishing Group 2019-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/7/e026733.full
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author Noriko Sasaki
Yuichi Imanaka
Takayo Nakabe
Hironori Uematsu
Susumu Kunisawa
Anders Wimo
author_facet Noriko Sasaki
Yuichi Imanaka
Takayo Nakabe
Hironori Uematsu
Susumu Kunisawa
Anders Wimo
author_sort Noriko Sasaki
collection DOAJ
description Objective The purpose of this study was to clarify the microlevel determinants of the economic burden of dementia care at home in Japanese community settings by classifying them into subgroups of factors related to people with dementia and their caregivers.Design A cross-sectional online survey.Participants 4313 panels of Japanese research company who fulfilled the following criteria: (1) aged 30 years or older, (2) non-professional caregiver of someone with dementia, (3) caring for only one person with dementia and (4) having no conflicts of interest with advertising or marketing research entities.Primary outcome measures Informal care costs and out-of-pocket payments for long-term care (LTC) services.Results From 4313 respondents, only 1383 caregivers in community-settings were included in this analysis. We conducted a χ² automatic interaction detection analysis to identify the factors related to each cost (informal care costs and out-of-pocket payments for LTC services) divided into subcategories. In the resultant classifications, informal care cost was mainly related to caregivers’ employment status. When caregivers acquired family care leave, informal care costs were the highest. On the other hand, out-of-pocket payments for LTC were related to care-need levels and family economic status. Activities of Daily Living and Instrumental Activities of Daily Living functions such as bathing, toileting and cleaning were related to all costs.Conclusion This study clarified the difference in dementia care costs between classified subgroups by considering the combination of the situations of both people with dementia and their caregivers. Informal care costs were related to caregivers’ employment and cohabitation status rather to the situations of people with dementia. On the other hand, out-of-pocket payments for LTC services were related to care-need levels and family economic status. These classifications will be useful in understanding which situation represents a greater economic burden and helpful in improving the sustainability of the dementia care system in Japan.
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spelling doaj-art-2150d217cf6b4f24bfa7e5f4c0c484912024-11-23T17:10:12ZengBMJ Publishing GroupBMJ Open2044-60552019-07-019710.1136/bmjopen-2018-026733Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online surveyNoriko Sasaki0Yuichi Imanaka1Takayo Nakabe2Hironori Uematsu3Susumu Kunisawa4Anders Wimo51 Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, Kyoto, JapanDepartment of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, School of Public Health, Kyoto, Japan1 Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, Kyoto, Japan1 Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, Kyoto, JapanDepartment of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, School of Public Health, Kyoto, Japan2 Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, SwedenObjective The purpose of this study was to clarify the microlevel determinants of the economic burden of dementia care at home in Japanese community settings by classifying them into subgroups of factors related to people with dementia and their caregivers.Design A cross-sectional online survey.Participants 4313 panels of Japanese research company who fulfilled the following criteria: (1) aged 30 years or older, (2) non-professional caregiver of someone with dementia, (3) caring for only one person with dementia and (4) having no conflicts of interest with advertising or marketing research entities.Primary outcome measures Informal care costs and out-of-pocket payments for long-term care (LTC) services.Results From 4313 respondents, only 1383 caregivers in community-settings were included in this analysis. We conducted a χ² automatic interaction detection analysis to identify the factors related to each cost (informal care costs and out-of-pocket payments for LTC services) divided into subcategories. In the resultant classifications, informal care cost was mainly related to caregivers’ employment status. When caregivers acquired family care leave, informal care costs were the highest. On the other hand, out-of-pocket payments for LTC were related to care-need levels and family economic status. Activities of Daily Living and Instrumental Activities of Daily Living functions such as bathing, toileting and cleaning were related to all costs.Conclusion This study clarified the difference in dementia care costs between classified subgroups by considering the combination of the situations of both people with dementia and their caregivers. Informal care costs were related to caregivers’ employment and cohabitation status rather to the situations of people with dementia. On the other hand, out-of-pocket payments for LTC services were related to care-need levels and family economic status. These classifications will be useful in understanding which situation represents a greater economic burden and helpful in improving the sustainability of the dementia care system in Japan.https://bmjopen.bmj.com/content/9/7/e026733.full
spellingShingle Noriko Sasaki
Yuichi Imanaka
Takayo Nakabe
Hironori Uematsu
Susumu Kunisawa
Anders Wimo
Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey
BMJ Open
title Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey
title_full Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey
title_fullStr Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey
title_full_unstemmed Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey
title_short Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey
title_sort classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in japan a cross sectional online survey
url https://bmjopen.bmj.com/content/9/7/e026733.full
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