Association between the disability prevention program "Secondary Preventive Services" and disability incidence among the elderly population: A nationwide longitudinal comparison of Japanese municipalities.
AIM
The aim of the present ecological study was to evaluate the relationship between the rate of participation in Secondary Preventive Services (SPS) and the incidence of disability in Japanese municipalities.


METHODS
We used the national statistics data for Long-term Care Insurance (LTCI), because all Japanese people aged ≥65 years are eligible for LTCI services depending on their functional status assessed by a national uniform standard in all municipalities. The disability incidence rate for the 2-year period in 2009-2010 was compared among five different levels of SPS participation in 2006-2008. The primary outcome was the sum total disability incidence rate in LTCI from 2009 to 2010. The outcome was divided according to disability level into three patterns: "all levels (Support Level 1 - Care Level 5)", "mild disability (Care Level ≤1)" and "moderate to severe disability (Care Level ≥2)".


RESULTS
There was a significant inverse association between the SPS participation rate and disability incidence rate. Among 1541 municipalities, those in the highest SPS participation rate quintile (≥9.79 per 1000 elderly population) had a lower disability incidence rate for all levels than those in the lowest quintile (<1.86 per 1000 elderly population; absolute rate difference 0.6%; age-adjusted incident rate ratio 0.94; 95% CI 0.89-0.99). This inverse association was observed for mild disability and not for moderate to severe disability.


CONCLUSIONS
Municipalities with a higher SPS participation rate have a lower incidence rate of mild disability. SPS could be an effective health policy for containing mild disability incidence among the elderly.
['Tomata|Yasutake|Y|', 'Sone|Toshimasa|T|', 'Chou|Wan-Ting|WT|', 'Tsuboya|Toru|T|', 'Watanabe|Takashi|T|', 'Kakizaki|Masako|M|', 'Tsuji|Ichiro|I|']
D000368:Aged D000369:Aged, 80 and over D004185:Disability Evaluation D006233:Disabled Persons D005260:Female D015577:Geriatric Assessment D006801:Humans D015994:Incidence D007353:Insurance, Long-Term Care D007564:Japan D008137:Longitudinal Studies D008297:Male D010342:Patient Acceptance of Health Care D055502:Secondary Prevention
disability disability prevention program municipality Japan