Updated on 2022/05/26

写真a

 
KAWAMURA, Akira
 
Affiliation
Faculty of Human Sciences, School of Human Sciences
Job title
Professor(tenure-track)

Concurrent Post

  • Faculty of Human Sciences   Graduate School of Human Sciences

  • Faculty of Human Sciences   School of Human Sciences (Online Degree Program)

  • Faculty of Political Science and Economics   Graduate School of Political Science

 

Research Areas

  • Public economics and labor economics

Papers

  • Relationship between School Attendance Support and Academic Performance: An Analysis of Panel Data from Adachi Ward

    NOGUCHI Haruko, BESSHO Shun-ichiro, USHIJIMA Koichi, KAWAMURA Akira, TANAKA Ryuichi

    Public Policy Review   16 ( 6 )  2020.09

  • Building an Administrative Database of Children

    BESSHO Shun-ichiro, NOGUCHI Haruko, TANAKA Ryuichi, USHIJIMA Koichi, KAWAMURA Akira

    Public Policy Review   16 ( 6 )  2020.09

  • Benefits of knowing own health status: effects of health check-ups on health behaviours and labour participation

    Cheolmin Kang, Akira Kawamura, Haruko Noguchi

    Applied Economics Letters   28 ( 11 ) 1 - 6  2020.07

    DOI

  • Differences in cancer patients’ work-cessation risk, based on gender and type of job: Examination of middle-aged and older adults in super-aged Japan

    Shuhei Kaneko, Haruko Noguchi, Rong Fu, Cheolmin Kang, Akira Kawamura, Shinsuke Amano, Atsushi Miyawaki

    PLOS ONE   15 ( 1 ) e0227792 - e0227792  2020.01

    DOI

  • 区立小学校での補習の効果:足立区のケース

    別所俊一郎, 田中隆一, 牛島光一, 川村顕, 野口晴子

    フィナンシャル・レビュー   ( 141 ) 141 - 159  2019.12

  • 就学援助と学力との関連性について: 足立区におけるパネルデータ分析結果から

    野口晴子, 別所俊一郎, 牛島光一, 川村顕, 田中隆一

    フィナンシャル・レビュー   ( 141 ) 120 - 140  2019.12

  • 子どもについての行政データベースの構築

    別所俊一郎, 野口晴子, 田中隆一, 牛島光一, 川村顕

    フィナンシャル・レビュー   ( 141 ) 106 - 119  2019.12

  • Evaluating remedial education in elementary schools: Administrative data from a municipality in Japan

    Bessho Shun-ichiro, Noguchi Haruko, Kawamura Akira, Tanaka Ryuichi, Ushijima Koichi

    JAPAN AND THE WORLD ECONOMY   50   36 - 46  2019.06  [Refereed]

     View Summary

    In this study, we examine the effect of a remedial education program in language arts and mathematics for third and fourth-grade students with low previous academic performance. Utilizing a unique panel data set constructed from the administrative data of public elementary schools in Adachi ward in Japan, we estimate the impact of remedial program participation on the subsequent test scores in Japanese language arts and mathematics. This paper utilizes the variations in placement policies of schools as an instrument to identify the effect of the remedial education program, controlling for selection biases. Our estimation results indicate that the remedial education programs had positive effects on test scores of Japanese language arts by 0.13 of a standard deviation, while no statistically significant effect was found for mathematics test scores. The results suggest that the participants increased awareness of the importance of study practices and hours of study as well.

    DOI

  • How do cardiovascular diseases harm labor force participation? Evidence of nationally representative survey data from Japan, a super-aged society.

    Fu R, Noguchi H, Kaneko S, Kawamura A, Kang C, Takahashi H, Tamiya N

    PloS one   14 ( 7 ) e0219149  2019  [Refereed]  [International journal]

     View Summary

    OBJECTIVE: To evaluate how cardiovascular diseases harm labor force participation (LFP) among the Japanese population and verify the validity of plasma biomarkers as instrumental variables of cardiovascular diseases after adjusting for a broad set of confounders including dietary intake. DESIGN: Using nationally representative repeated cross-sectional surveys in Japan, the Comprehensive Survey of Living Conditions and National Health and Nutrition Survey, with plasma biomarkers as instrumental variables for quasi-randomization. SETTING: Onset of cardiovascular diseases in those receiving regular treatment for hypertension, intracerebral hemorrhage, intracerebral infarction, angina pectoris, myocardial infarction, or other types of cardiovascular diseases. PARTICIPANTS: A total of 65,615 persons aged ≥ 20 years (35,037 women and 30,578 men) who completed a survey conducted every three years from 1995 through 2013. MAIN OUTCOME MEASURES: Respondent employment and weekly working hours during each survey year. RESULTS: Cardiovascular diseases significantly and remarkably reduced the probability of working by 15.4% (95% CI: -30.6% to -0.2%). The reduction in working probability was detected for women only. Respondents aged ≥ 40 years were less likely to work once diagnosed and the reduction was enlarged for those aged ≥ 65 years, while those aged < 40 years appeared to be unaffected. Probability of engaging in manual labor significantly decreased once diagnosed; however, no impact was found for cognitive occupations. Among employed respondents, the adverse effects of cardiovascular diseases decreased working hours by five hours per week. Validity of the biomarker instrumental variables was generally verified. CONCLUSIONS: A vicious circle is suggested between LFP and unfavorable health. However, the effects vary across age, sex, and occupation type, even after adjusting for causal effects, which could cause a downward bias in LFP impact. ATTRIBUTES: cardiovascular disease, labor force participation, instrumental variable method as quasi-randomization, plasma biomarker, Comprehensive Survey of Living Conditions, National Health and Nutrition Survey.

    DOI PubMed

  • Effect of short-stay service use on stay-at-home duration for elderly with certified care needs: Analysis of long-term care insurance claims data in Japan

    Yoko Moriyama, Nanako Tamiya, Akira Kawamura, Thomas D. Mayers, Haruko Noguchi, Hideto Takahashi

    Plos One   13 ( 8 ) e0203112  2018.08  [Refereed]

  • Resident and facility characteristics associated with care-need level deterioration in long-term care welfare facilities in Japan: a population-based retrospective cohort study

    Jin Xueying, Nanako Tamiya, Jeon Boyoung, Akira Kawamura, Hideto Takahashi, Haruko Noguchi

    Geriatrics & Gerontology International   18 ( 5 ) 758 - 766  2018.05  [Refereed]

  • Resident and facility characteristics associated with care-need level deterioration in long-term care welfare facilities in Japan

    Xueying Jin, Nanako Tamiya, Boyoung Jeon, Akira Kawamura, Hideto Takahashi, Haruko Noguchi

    Geriatrics and Gerontology International   18 ( 5 ) 758 - 766  2018.05  [Refereed]

     View Summary

    Aim: To determine the resident and facility characteristics associated with residents’ care-need level deterioration in long-term care welfare facilities in Japan. Methods: A nationally representative sample of 358 886 residents who lived in 3774 long-term care welfare facilities for at least 1 year from October 2012 was obtained from long-term care insurance claims data. Facility characteristics were linked with a survey of institutions and establishments for long-term care in 2012. We used a multilevel logistic regression according to the inclusion and exclusion of lost to follow-up to define the resident and facility characteristics associated with resident care-need level deteriorations (lost to follow-up: the majority were hospitalized residents or had died
    were treated as deterioration in the including loss to follow-up model). Results: Adjusting for the covariates, at the resident level, older age and lower care-need level at baseline were more likely to show deterioration in the care-need level. At the facility level, metropolitan facilities, unit model (all private room settings) and mixed-model facilities (partly private room settings) were less likely to experience care-need level deterioration. A higher proportion of registered nurses among all nurses was negatively related to care-need level deterioration only in the model including lost to follow-up. A higher proportion of registered dietitians among all dietitians and the facilities in business for fewer years were negatively associated with care-need level deterioration only in the model excluding lost to follow-up. Conclusions: The present study could help identify residents who are at risk of care-need level deterioration, and could contribute to improvements in provider quality performance and enhance competence in the market. Geriatr Gerontol Int 2018
    18: 758–766.

    DOI

  • 訪問診療3か月以上継続と多職種による居宅サービスの併用との関連

    阿部計大, 小林廉毅, 川村顕, 野口晴子, 高橋秀人, 田宮菜奈子

    An official journal of the Japan Primary Care Association   41 ( 1 ) 2 - 7  2018.03  [Refereed]

  • The Association between Continuation of Home Medical Care and Utilization of Other Home Care Services for Older People with Long-term Care Insurance in Japan

    Kazuhiro Abe, Yasuki Kobayashi, Akira Kawamura, Haruko Noguchi, Hideto Takahashi, Nanako Tamiya

    An Official Journal of the Japan Primary Care Association   41 ( 1 ) 2‐7(J‐STAGE)  2018  [Refereed]

    J-GLOBAL

  • Spillover effect of Japanese long-term care insurance as an employment promotion policy for family caregivers

    Rong Fu, Haruko Noguchi, Akira Kawamura, Hideto Takahashi, Nanako Tamiya

    Journal of Health Economics   56   103 - 112  2017.12  [Refereed]

     View Summary

    We evaluate a spillover effect of the Japanese public long-term care insurance (LTCI) as a policy to stimulate family caregivers’ labor force participation. Using nationally representative data from 1995 to 2013, we apply difference-in-difference propensity score matching to investigate the spillover effect in two periods: before and after the introduction of the LTCI in 2000 and before and after its major amendment in 2006. Our results show that the LTCI introduction has significant and positive spillover effects on family caregivers’ labor force participation and the effects vary by gender and age. In contrast, the LTCI amendment is found to have generally negative spillover effects on their labor force participation. We draw attention to these spillover effects, as expanding labor market supply to sustain the economy would be a priority for Japan and other rapidly aging countries in the coming decades.

    DOI

  • 地域包括ケアシステムの評価指標としての在宅期間-8年間の全国介護レセプトデータによる検討-

    植嶋大晃, 高橋秀人, 野口晴子, 川村顕, 松本吉央, 森山葉子, 田宮菜奈子

    Journal of Health and Welfare Statistics   64 ( 5 ) 8 - 18  2017.12  [Refereed]

  • Relation between social network and psychological distress among middle-aged adults in Japan: Evidence from a national longitudinal survey

    Rong Fu, Harkuo Noguchi, Hirokazu Tachikawa, Miyuki Aiba, Shin Nakamine, Akira Kawamura, Hideto Takahashi, Nanako Tamiya

    SOCIAL SCIENCE & MEDICINE   175   58 - 65  2017.02  [Refereed]

     View Summary

    It is widely documented that psychological distress is negatively associated with social networks involvement. However, despite the theoretical postulations that social networks are crucial for alleviating psychological distress, no study has yet empirically confirmed the causality of this relationship. Thus, we used the random-effects generalized least squares method to investigate the effect of one- and two-year lagged values for involvement in social networks on psychological distress. Nine years of longitudinal data were extracted from a nationally representative survey in Japan ("The Longitudinal Survey of Middle-aged and Older Persons"). We utilized the Kessler 6 (K6) score to measure psychological distress among 15,242 respondents aged 50-59 years in the baseline year (2005), and stratified participants into three layers of social networks: inner (well-established friendship ties and participating in hobby activates), intermediary (neighborly ties), and outer (involvement in community activities). We found highly significant and negative associations between all three layers and K6 scores, with the strongest association being for the inner layer. We further observed that one-year lagged involvement in the inner and intermediary layers led to significantly lower K6 scores. However, the protective influences of social networks generally diminished over time. In addition, the protective influences of social network involvement on psychological distress were stronger for women than for men. Furthermore, involvement in social networks was especially important for improving mental health among people with psychological distress. These findings would be important for policymaking to prevent mental health deterioration among middle-aged adults in Japan. (C) 2017 Elsevier Ltd. All rights reserved.

    DOI PubMed

  • The relationship between raising a child with a disability and the mental health of mothers compared to raising a child without disability in japan

    Yui Yamaoka, Nanako Tamiya, Nobuyuki Izumida, Akira Kawamura, Hideto Takahashi, Haruko Noguchi

    SSM - Population Health   2   542 - 548  2016.12  [Refereed]

     View Summary

    Objective Previous studies conducted in Japan targeted only mothers who cared for children with disabilities, and lacked reference subjects, such as mothers of children without disabilities. The aim of this study was to examine the association between raising one or two children with a disability and maternal psychological distress compared to mothers of children without a disability, and to assess differences among partnered mothers living with grandparent(s), partnered mothers without grandparent(s), and single mothers. Methods This study utilized data from the Comprehensive Survey of Living Conditions (CSLC) in 2010. We merged the data of the children (aged six and over), mothers, and fathers. This study obtained 33,739 study subjects as a triad of a child (33,110 children without disabilities and 629 children with disabilities), mother, and father. The Japanese version of Kessler 6 (K6) was used to assess the psychological distress of mothers. Multivariate logistic regression was performed to assess the independent association of a child with a disability on maternal psychological distress after controlling for the basic characteristics of the children, mothers, and households. Results This study reported that raising one or two children with disabilities was significantly related to maternal psychological distress (odds ratio: 1.72 for one child, 2.85 for two children) compared to mothers of children without disability. After stratifying the analyses by family structure, significant associations remained among mothers in two-parent families but not for mothers in three-generation families and single mothers due to a small number of children with disabilities in these families. Conclusions This study reported the significant association between raising a child with a disability and maternal psychological distress in comparison to mothers of children without disabilities. Attention should be paid to not only single mothers, but also partnered mothers in two-parent families who have a child with a disability. It is important for health professionals to focus on the mental health of every mother of a child with a disability and to assess their needs for psychological support.

    DOI PubMed

  • 全国介護レセプトを用いた経口移行者実態把握の試み

    川村顕, 田宮菜奈子, 泉田信行, 植嶋大晃, 高橋秀人, 野口晴子

    Journal of Health and Welfare Statistics   63 ( 15 ) 29 - 36  2016.12  [Refereed]

  • Budget systems and expenditure for national health insurance and nursing care insurance

    Akira Kawamura, Haruko Noguchi

    mimeo    2016.03

  • 新卒医師の研修先決定要因

    川村顕

    Hospital   69 ( 12 ) 1005 - 1009  2009.12

  • Who has benefited from the health services system for the elderly in Japan?

    Atsushi Yoshida, Akira Kawamura

    JAPAN AND THE WORLD ECONOMY   21 ( 3 ) 256 - 269  2009.08  [Refereed]

     View Summary

    This paper examines the demand and supply of medical services for the elderly in the health services system characterized by per-month fixed copayment and selective capitation fee scheme for outpatients with chronic diseases. The results indicate that the beneficiary, in particular the household dependent, visits a physician more frequently because the actual copayment decreases for the household dependent, but is nearly the same for the head of the household. Physicians, however, provide more services to the beneficiary partly because of the lowered copayment and partly because of the capitation fee scheme, which they will select instead of the fee-for-service scheme only when capitation is more profitable than Fee-for-Service. As a result, physicians as well as the insured benefit from the health services system. (C) 2008 Elsevier B.V. All rights reserved.

    DOI

  • 女性医師のキャリア選択-病院/診療所選択の男女比較-

    川村顕

    The Japanese Society of Health and Medical Sociology   19 ( 2 ) 94 - 104  2009.01  [Refereed]

  • 市町村国民健康保険データベースを用いた費用効率性分析

    吉田あつし, 山村麻里子, 川村顕

    筑波大学多目的統計データバンク年報   80   41 - 63  2004.03

  • Changes in Supply and Demand for Dental Services after the 1997 Reform of the Copayment Rate

    Atsushi Yoshida, Akira Kawamura

    Journal of Health Care and Society   13 ( 4 ) 95 - 112  2004.03  [Refereed]

  • 被保険者のモラルハザードと医師の代理者機能:97 年自己負担率改定における歯科のケース

    吉田あつし, 川村顕

    Institute of Policy and Planning Sciences Discussion Paper Series   1025   1 - 24  2002.02

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Books and Other Publications

  • 医療システムの経済分析, 『シリーズ生命倫理学17巻 医療制度・医療政策・医療経済』第12章

    吉田あつし, 川村顕

    丸善出版  2013.02

Misc

  • 新卒医師の研修先決定要因 (特集 今後の医師養成と病院)

    川村 顕

    病院   68 ( 12 ) 1005 - 1009  2009.12

    CiNii

Research Projects

  • 介護保険利用者のアクセシビリティの変化と格差:ビッグデータを用いた分析

    Project Year :

    2017.04
    -
    2020.03
     

     View Summary

    29年度は主にデータベース構築を行う予定であったが、データ入手に時間を要した。その間、先行研究の精査と仮説の構築に努めるとともに、入手予定のデータ間でのリンケージ可能性について考察した。また、速やかなリンケージを可能にするため、必要なプログラムを作成してきた。本研究に用いるデータソースは厚生労働省所管統計調査個票、総務省書簡統計調査個票であるため、二次利用申請手続きを行ったが、厚生労働省からデータを入手するのに時間を要した。データ利用承諾後の2018年5月13日現在、本研究の中心的データである介護レセプトは未着であるものの、利用許諾は得ているので、到着次第、速やかなデータクリーニングを開始する。データが到着しつつあるので、30年度は今年度上半期にデータベース構築を終了させ、下半期では利用者自己負担改定とサービス利用との関係について分析を行う。データベース構築については、介護レセプト、介護サービス施設・事

  • An Empirical Research on the Accumulation Mechanism of Children's Human Capital: Lessons from Challenge of Adachi Ward in Tokyo Prefecture

    Project Year :

    2016.04
    -
    2019.03
     

  • Study for representativeness and maintenance of Comprehensive Survey of Living Conditions and Survey of Long-term Care Benefit Expenditures

    Project Year :

    2015.10
    -
    2018.03
     

     View Summary

    For Comprehensive Survey of Living Conditions (CSLC), large-scale survey every three years and Small-scale survey in each interim year of Large-scale survey year, survey districts were reviewed to National Census every 5 years. The size of survey districts was around 50 households and inflation factor amplified estimation error. So the influence on the results of movement of young people and single-household cannot be ignored.For Survey of Long-term Care Benefit Expenditures (SLCBE), data are provided the set which consist of basic information (H1), collective information (T1), detailed information (D1), cost plan for household services (D5), Recipient ledger (M). We extracted the data on a monthly basis by managing them with the structure, individual × the number of applied facilities ×months (H1), the kind of service × the number of applied facilities × months (T1), (service id) × the number of applied facilities × months (D1), individual × months (M)

  • The empirical study of the decision mechanism of the premium and the subsidies in the municipality-based health care insurance system in Japan

    Project Year :

    2011.04
    -
    2014.03
     

     View Summary

    The aim of the study is to clear the decision mechanism of the premium and the subsidies in the municipality-based health care insurance system in Japan. In the research, I address two questions: first, whether does the subsidy mechanism bring the differences of inefficiency of service use? Second, whether do political factors such as seniority of a mayor or structure of an assembly affect the decision of premium rate?First, I compared the health care insurance with the long-term care insurance in a same municipality. Employing the stochastic cost frontier model, I showed the difference of the inefficiency in two systems. The inefficiency of the health care system was larger than that of LTC.Second, I estimated the regression of the premium equation on the seniority of a mayor and other political factors with some control variables. The estimation result showed that just the seniority of a mayor was positively significant, and other political factors were not significant

Presentations

  • The budget system and inefficiency for national health and long term care insurance

    The 12th Europian Conference on Health Economics  (Maastricht)  Maastricht University

    Presentation date: 2018.07

  • Do Preventive Long-Term Care services reduce future expenditures? : A case of Public Long-Term Care Insurance System in Japan

    The 2017 Congress of International Health Economics Association  (Boston)  Boston University

    Presentation date: 2017.07

  • 介護予防給付の介護費用における効果 ―全国介護レセプトを用いて

    The 75th Annual Meeting of Japanese Society of Public Health  (Osaka)  Osaka University

    Presentation date: 2016.10

  • 介護予防サービス利用は要介護状態移行後の介護支出を軽減するか?-全国介護レセプトデータを用いた検証-

    The 73rd Congress of Japan Association of Public Finance  (Kyoto)  Kyoto Sangyo University

    Presentation date: 2016.10

  • 介護予防サービス利用は要介護状態移行後の介護支出を軽減するか?―全国介護レセプトデータを用いた検証

    The 11th Annual Meeting of Japan Health Economics Association  (Tokyo)  Waseda University

    Presentation date: 2016.09

  • 全国介護レセプトデータを用いた介護保険施設における経管栄養者の経口移行の実態

    The 74th Annual Meeting of Japanese Society of Public Health  (Nagasaki)  Nagasaki University

    Presentation date: 2015.11

  • 介護保険レセプトを用いた介護保険サービスの質の評価

    "The present and the future of health services research", Symposium #23 in Japanese Society of Public Health  (Nagasaki)  Nagasaki University

    Presentation date: 2015.11

  • The trial of the shift from tubal to oral feeding in long-term care facilities: a descriptive analysis of the difference among Care-Levels, facility types and prefectures in Japan

    3rd International Conference on Global Aging  (Tsukuba)  University of Tsukuba

    Presentation date: 2015.09

  • 公共下水道の効率性に関する実証分析

    The 71st Congress of Japan Association of Public Finance  (Nagoya)  Chukyo University

    Presentation date: 2014.10

  • 国民健康保険と介護保険における予算制度と支出

    The 69th Congress of Japan Association of Public Finance  (Awaji, Hyogo)  Osaka University

    Presentation date: 2012.10

  • 介護保険制度改革が施設サービス利用者に与える影響―レセプトデータを用いて―

    The 66th Congress of Japan Association of Public Finance  (Tokyo)  Meiji Gakuin University

    Presentation date: 2010.10

  • 新卒医師の病院選択要因

    9th Health Economics Research Meeting in 2018  (Tokyo)  The Health Care Science Institute

    Presentation date: 2009.02

  • Budget Systems and Moral Hazard in the National Health Insurance and the Long-term Care Insurance

    Japanese Economic Association 2008 Autumn Meeting  (Higashi-Osaka)  Kindai University

    Presentation date: 2008.09

  • 下水道事業の効率性と補助金

    Japanese Economic Association 2008 Spring Meeting  (Sendai)  Tohoku University

    Presentation date: 2008.05

  • 新医師臨床研修制度導入と新卒医師の就業選択

    2nd Health Economics Research Meeting in 2018  (Tokyo)  The Health Care Science Institute

    Presentation date: 2008.05

  • 下水道事業の効率性と補助金

    21st Annual Meeting of the Applied Regional Science Conference  (Tottori)  Tottori University

    Presentation date: 2007.12

  • Who has benefited from the health services system for the elderly in Japan?

    2007 Far Eastern Meeting of the Econometric Society  (Taipei)  Academia Sinica

    Presentation date: 2007.07

  • Competition and Physician Induced Demand: Evidence from Dental Service Market in Japan

    Japanese Economic Association 2006 Autumn Meeting  (Osaka)  Osaka City University

    Presentation date: 2006.10

  • 歯科医院の参入が医療費及び経済厚生に与える効果

    19th Annual Meeting of the Applied Regional Science Conference  (Urayasu)  Meilai University

    Presentation date: 2005.12

  • Effects of entry of dental clinics on medical expenditure or economic welfare

    12th Annual International Conference on Statistics, Combinatorics, Mathematics and Applications, Forum for Interdisciplinary Mathematics  (Auburn, Alabama)  Auburn University

    Presentation date: 2005.12

  • 被保険者のモラルハザードと医師の代理者機能:97年自己負担率改定における歯科のケース

    Japanese Economic Association 2003 Spring Meeting  (Oita)  Oita University

    Presentation date: 2003.06

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Specific Research

  • 介護予防給付利用有無が介護給付費に与える影響に関する実証分析

    2017  

     View Summary

    本研究では、要支援者の予防介護利用の有無が、要介護状態移行後の介護支出に違いをもたらすかどうかを分析の目的とした。分析には介護給付費実態調査個票を用い、要支援時をベースラインとした傾向スコアマッチングを行った。要介護1以上に移行後の1か月あたり介護支出における平均処置効果を算出した。その結果、①1か月あたり介護支出全体、および、居宅サービスにおいては、介護予防サービス利用群が非利用群を上回った。また、②施設サービスにおいては非利用群が利用群を上回った。ただし、①においてはその差が利用月数の増加とともに縮小し、②においては利用月数が増加してもその差は縮小しないことがわかった。

  • 介護予防給付利用有無が介護給付費に与える影響に関する実証分析

    2017  

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    本研究では、要支援者の予防介護利用の有無が、要介護状態移行後の介護支出に違いをもたらすかどうかを分析の目的とした。分析には介護給付費実態調査個票を用い、要支援時をベースラインとした傾向スコアマッチングを行った。要介護1以上に移行後の1か月あたり介護支出における平均処置効果を算出した。その結果、①1か月あたり介護支出全体、および、居宅サービスにおいては、介護予防サービス利用群が非利用群を上回った。また、②施設サービスにおいては非利用群が利用群を上回った。ただし、①においてはその差が利用月数の増加とともに縮小し、②においては利用月数が増加してもその差は縮小しないことがわかった。

 

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