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.
Aged Aged, 80 and over