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Open Access 01-12-2022 | Research

Implementation and costs of housing adaptations among older adults with different functional limitations in Japan

Authors: Rumiko Tsuchiya-Ito, Shota Hamada, Björn Slaug, Ayako Ninomiya, Kazuaki Uda, Tomoaki Ishibashi

Published in: BMC Geriatrics | Issue 1/2022

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Abstract

Background

Accessible housing is crucial to maintain a good quality of life for older adults with functional limitations, and housing adaptations are instrumental in resolving accessibility problems. It is unclear to what extent older adults, who have a high risk of further functional decline, use housing adaptation grants acquired through the long-term care (LTC) insurance systems. This study aimed to examine the utilization of housing adaptation grants in terms of implementation and costs, for older adults with different types of functional limitations related to accessibility problems.

Methods

The study sample included individuals from a suburban city in the Tokyo metropolitan area who were certified for care support levels (indicative of the need for preventive care) for the first time between 2010 and 2018 (N = 10,372). We followed the study participants over 12 months since the care needs certification. We matched and utilized three datasets containing the same individual’s data: 1) care needs certification for LTC insurance, 2) insurance premium levels, and 3) LTC insurance claims. We conducted a multivariable logistic regression analysis to estimate the likelihood of individuals with different functional limitations of having housing adaptations implemented. Afterward, we conducted a subgroup analysis of only older adults implementing housing adaptation grants to compare costs between groups with different functional limitations using the Mann–Whitney U and Kruskal–Wallis tests.

Results

Housing adaptations were implemented among 15.6% (n = 1,622) of the study sample, and the median cost per individual was 1,287 USD. Individuals with lower extremity impairment or poor balance were more likely to implement housing adaptations (adjusted odds ratio (AOR) = 1.290 to AOR = 2.176), while those with visual impairment or lower cognitive function were less likely to implement housing adaptations (AOR = 0.553 to AOR = 0.861). Costs were significantly lower for individuals with visual impairment (1,180 USD) compared to others (1,300 USD).

Conclusion

Older adults with visual or cognitive limitations may not receive appropriate housing adaptations, despite their high risk of accessibility problems. Housing adaptation grants should include various types of services that meet the needs of older people with different disabilities, and the results indicate there may be a need to improve the system.
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Metadata
Title
Implementation and costs of housing adaptations among older adults with different functional limitations in Japan
Authors
Rumiko Tsuchiya-Ito
Shota Hamada
Björn Slaug
Ayako Ninomiya
Kazuaki Uda
Tomoaki Ishibashi
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2022
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-022-03100-9

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