Abstract：
:The introduction of Japan's long-term care insurance (LTCI) system in April 2000 has made long-term care an explicit and universal entitlement for every Japanese person aged 65 and older based strictly on physical and mental status. At the start of the program, more than two million seniors were expected to apply for services to approximately 3,000 municipal governments, which are the LTCI insurers. The LTCI implementation required a nationally standardized needs-certification system to determine service eligibility objectively, fairly, and efficiently. The current computer-aided initial needs-assessment instrument was developed based on data collected in a large-scale time study of professional caregivers in long-term care institutions. The instrument was subsequently tested and validated by assessing data of 175,129 seniors involved in the national model programs before the start of LTCI. The computer-aided initial assessment (an 85-item questionnaire) is used to assign each applicant to one of seven need levels. The Care Needs Certification Board, a committee of medical and other professionals, reviews the results. Three years after implementation, the LTCI system and its needs-assessment/certification system have been well accepted in Japan. Despite the overall successes, there remain challenges, including area variations, growing demands for services, and the difficulty of keeping the needs certification free of politics. The LTCI computer network that links municipalities and the central government is instrumental in continuously improving the needs-certification system. Future challenges include promoting evidence-based system improvements and building incentives into the system for various constituencies to promote seniors' functional independence.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Tsutsui T,Muramatsu Ndoi
10.1111/j.1532-5415.2005.53175.xsubject
Has Abstractpub_date
2005-03-01 00:00:00pages
522-7issue
3eissn
0002-8614issn
1532-5415pii
JGS53175journal_volume
53pub_type
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journal_title：Journal of the American Geriatrics Society
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journal_title：Journal of the American Geriatrics Society
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journal_title：Journal of the American Geriatrics Society
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journal_title：Journal of the American Geriatrics Society
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doi：10.1111/j.1532-5415.1998.tb01047.x
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journal_title：Journal of the American Geriatrics Society
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doi：10.1111/jgs.12651
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journal_title：Journal of the American Geriatrics Society
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1111/j.1532-5415.1982.tb01982.x
更新日期：1982-11-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1046/j.1532-5415.2001.49179.x
更新日期：2001-07-01 00:00:00
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doi：10.1111/j.1532-5415.2006.00835.x
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abstract：OBJECTIVES:To examine whether sleep disturbance is associated with poor physical function in older veterans in an adult day healthcare (ADHC) program. DESIGN:Cross-sectional. SETTING:One ADHC program in a Veterans Affairs Ambulatory Care Center. PARTICIPANTS:Older veterans (N = 50) enrolled in a randomized controlle...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章,随机对照试验
doi：10.1111/jgs.13527
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abstract：OBJECTIVE:To determine the excess mortality associated with obesity (defined by body mass index (BMI)) in older people, with and without adjustment for other risk factors associated with mortality and for demographic factors. DESIGN:Retrospective cohort analysis of the Longitudinal Study of Aging (LSOA). SETTING:Nati...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1046/j.1532-5415.2001.49189.x
更新日期：2001-07-01 00:00:00
abstract：OBJECTIVES:To identify patterns and predictors of antithrombotic use and to evaluate the appropriateness of antithrombotic therapy for stroke prophylaxis in institutionalized elderly patients with atrial fibrillation. DESIGN:Retrospective study. SETTING:Seventeen long-term care institutions in Edmonton, Alberta. SUB...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.2004.52117.x
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章,评审
doi：10.1046/j.1532-5415.2003.51521.x
更新日期：2003-11-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
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doi：10.1111/j.1532-5415.2008.02025.x
更新日期：2008-12-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1046/j.1532-5415.2002.50021.x
更新日期：2002-01-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1987.tb04662.x
更新日期：1987-05-01 00:00:00
abstract：OBJECTIVES:To obtain population-based estimates of emergency department (ED) visits by long-term care (LTC) residents. DESIGN:Retrospective cohort study using administrative data. SETTING:All LTC facilities in Ontario, Canada. PARTICIPANTS:All LTC residents who visited an ED at least once during a 6-month period. M...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.2010.02736.x
更新日期：2010-03-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
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doi：10.1111/j.1532-5415.1999.tb01583.x
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journal_title：Journal of the American Geriatrics Society
pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：Journal of the American Geriatrics Society
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doi：10.1111/j.1532-5415.1993.tb06758.x
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更新日期：2013-01-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
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更新日期：2007-01-01 00:00:00
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更新日期：2020-09-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1998.tb03799.x
更新日期：1998-06-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1532-5415.2004.52300.x
更新日期：2004-07-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章,评审
doi：10.1111/j.1532-5415.2005.00569.x
更新日期：2006-01-01 00:00:00
abstract：OBJECTIVE:To determine if pre-complication nutrient intake can be predicted based on an admission assessment. DESIGN:Survey (cross-sectional study). SETTING:Geriatric Rehabilitation Unit (GRU) of a Veterans Administration hospital. PATIENTS:Three-hundred-twelve randomly selected admissions to the GRU. MEASUREMENTS:...
journal_title：Journal of the American Geriatrics Society
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doi：10.1111/j.1532-5415.1994.tb04967.x
更新日期：1994-05-01 00:00:00
abstract：OBJECTIVE:(1) To establish the range of cerebral atrophy across the adult age spectrum in optimally healthy, rigorously evaluated individuals. (2) To determine, across the age spectrum, the relation of gender and cerebral atrophy (as measured by ventricular enlargement) to cognitive function. DESIGN:Cross-sectional co...
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doi：10.1111/j.1532-5415.1992.tb02073.x
更新日期：1992-03-01 00:00:00
