Japanese Long-term Care Benefits for Nutrition and Oral Management

Objectives: The Japanese long-term care insurance (LTCI) system includes benefits of facility care service for: nutrition management, transition from tube feeding to oral ingestion, retention of oral ingestion (type 1 and 2: basic and additional fees, which are claimed for meal rounds by multidisciplinary teams, including oral health professionals (OHPs)), oral health management system, and oral health management (which needs participation of dental hygienists). However, some of these benefits are only seldom claimed. The purposes of this study were to: 1) investigate the claim rates for nutrition and oral management benefits in LTCI facilities; 2) determine the status of cooperation between LTCI facilities and OHPs; and 3) clarify factors that affect claiming.
Methods: We created a questionnaire on the current statuses of residents, staffing, cooperation with OHPs, and claims for the abovementioned oral health-related benefits and mailed it to all LTCI facilities in Niigata Prefecture, Japan. The response rate was 37%. Claim rates were calculated and logistic regression analysis was performed.
Results: Benefits for nutrition management were claimed in 95% of facilities, but those for transition from tube feeding to oral ingestion, retention of oral ingestion type 1, and 2 only in 9%, 39%, and 23%, respectively. Similarly, benefits for oral health management system were claimed in 68% of facilities, however, those for oral health management only in 17%. Although 92% of facilities established collaboration with dental institutions, only 16% of facilities employed OHPs. According to logistic regression analysis, factors strongly associated with claiming/not-claiming benefits for retention of oral ingestion type 2 and for oral health management were employment of OHPs and speech therapists by LTCI facilities.
Conclusions: Claim rates for benefits that need participation of OHPs were limited, but they could be improved by strengthening the cooperation between LTCI facilities and OHPs.