Receiving the home care service offered by certified care workers prior to a patients’ death and the probability of a home death: observational research using an instrumental variable method from Japan

Objectives To assess the association between receiving the certified care workers’ home care service, which is provided by non-medical professionals prior to a patients’ death and the probability of a home death.Design Observational research using the full-time translated number of certified care wo...

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Main Authors: Yasuki Kobayashi, Kazuhiro Abe, Atsushi Miyawaki, Haruko Noguchi, Hideto Takahashi, Nanako Tamiya
Format: Article
Language:English
Published: BMJ Publishing Group 2019-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/8/e026238.full
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author Yasuki Kobayashi
Kazuhiro Abe
Atsushi Miyawaki
Haruko Noguchi
Hideto Takahashi
Nanako Tamiya
author_facet Yasuki Kobayashi
Kazuhiro Abe
Atsushi Miyawaki
Haruko Noguchi
Hideto Takahashi
Nanako Tamiya
author_sort Yasuki Kobayashi
collection DOAJ
description Objectives To assess the association between receiving the certified care workers’ home care service, which is provided by non-medical professionals prior to a patients’ death and the probability of a home death.Design Observational research using the full-time translated number of certified care workers providing home care service per member of the population aged 65 or above, during the year prior to patient’s death per municipality as an instrumental variable.Setting The certified care workers’ home care service covered by the public long-term care insurance (LTCI) system in Japan.Participants In total, 1 613 391 LTCI beneficiaries aged 65 or above who passed away, except by an external cause of death, between January 2010 and December 2013 were included in the analysis.Primary outcome measures Death at home or death at other places, including hospitals, nursing homes and clinics with beds.Results Out of all participants, 173 498 (10.8%) died at home. The number of patients who used the certified care workers’ home care service more than once per each month during 1, 2 or 3 months prior to the month of death numbered 213 848, 176 686 and 155 716, respectively. This was associated with an increased probability of death at home by 9.1% points (95% CI 2.9 to 15.3), 10.5% points (3.3 to 17.6) and 11.4% points (3.6 to 19.2), respectively.Conclusions The use of the certified care workers’ home care service prior to death was associated with the increased probability of a home death.
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spelling doaj-art-cfb4375bc2574bfb95fd7d544f6916062025-08-20T02:27:50ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2018-026238Receiving the home care service offered by certified care workers prior to a patients’ death and the probability of a home death: observational research using an instrumental variable method from JapanYasuki Kobayashi0Kazuhiro Abe1Atsushi Miyawaki2Haruko Noguchi3Hideto Takahashi4Nanako Tamiya5Department of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, JapanDepartment of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, JapanFaculty of Political Science and Economics, Waseda University, Shinjuku-ku, Tokyo, JapanNational Institute of Public Health, Wako, Japan4 Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, JapanObjectives To assess the association between receiving the certified care workers’ home care service, which is provided by non-medical professionals prior to a patients’ death and the probability of a home death.Design Observational research using the full-time translated number of certified care workers providing home care service per member of the population aged 65 or above, during the year prior to patient’s death per municipality as an instrumental variable.Setting The certified care workers’ home care service covered by the public long-term care insurance (LTCI) system in Japan.Participants In total, 1 613 391 LTCI beneficiaries aged 65 or above who passed away, except by an external cause of death, between January 2010 and December 2013 were included in the analysis.Primary outcome measures Death at home or death at other places, including hospitals, nursing homes and clinics with beds.Results Out of all participants, 173 498 (10.8%) died at home. The number of patients who used the certified care workers’ home care service more than once per each month during 1, 2 or 3 months prior to the month of death numbered 213 848, 176 686 and 155 716, respectively. This was associated with an increased probability of death at home by 9.1% points (95% CI 2.9 to 15.3), 10.5% points (3.3 to 17.6) and 11.4% points (3.6 to 19.2), respectively.Conclusions The use of the certified care workers’ home care service prior to death was associated with the increased probability of a home death.https://bmjopen.bmj.com/content/9/8/e026238.full
spellingShingle Yasuki Kobayashi
Kazuhiro Abe
Atsushi Miyawaki
Haruko Noguchi
Hideto Takahashi
Nanako Tamiya
Receiving the home care service offered by certified care workers prior to a patients’ death and the probability of a home death: observational research using an instrumental variable method from Japan
BMJ Open
title Receiving the home care service offered by certified care workers prior to a patients’ death and the probability of a home death: observational research using an instrumental variable method from Japan
title_full Receiving the home care service offered by certified care workers prior to a patients’ death and the probability of a home death: observational research using an instrumental variable method from Japan
title_fullStr Receiving the home care service offered by certified care workers prior to a patients’ death and the probability of a home death: observational research using an instrumental variable method from Japan
title_full_unstemmed Receiving the home care service offered by certified care workers prior to a patients’ death and the probability of a home death: observational research using an instrumental variable method from Japan
title_short Receiving the home care service offered by certified care workers prior to a patients’ death and the probability of a home death: observational research using an instrumental variable method from Japan
title_sort receiving the home care service offered by certified care workers prior to a patients death and the probability of a home death observational research using an instrumental variable method from japan
url https://bmjopen.bmj.com/content/9/8/e026238.full
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