Oral Health Professional Involvement in Japanese Long-term Care Benefit Claims

Objectives: Among the benefits for facility care services of the Japanese long-term care insurance (LTCI) system, the following include participation of oral health professionals (OHPs): 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). OHP participation is required to claim benefits for oral health management system (oral care-related instruction of nursing staff) and oral health management (oral care implementation). In April 2015, amendments to the LTCI fees have been made, but their effect remains unknown. The purpose of this study was to investigate the involvement of oral health professionals in the oral ingestion-related services for which benefits were recently claimed by LTCI facilities in a Japanese prefecture.
Methods: An original questionnaire on the statuses of residents, staffing, cooperation with OHPs, and claims for the abovementioned oral health-related benefits as of December 2015 was mailed to all LTCI facilities (304) in Niigata Prefecture, Japan. On the basis of responses from 111 facilities, claim rates for each benefit and participation rates of OHPs in the oral ingestion-related services for which benefits were claimed, were calculated.
Results: While 68% of facilities claimed benefits for oral health management system, less than 40% claimed benefits for transition from tube feeding to oral ingestion, and retention of oral ingestion type 1 and 2. Claims for the 3 oral ingestion-related benefits included involvement of dentists (60%, 48%, and 36% of facilities) and dental hygienists (50%, 31%, and 48% of facilities). LTCI services provided by collaborating dental institutions were oral care instruction (77%) and dysphagia rehabilitation screening/instruction (32%).
Conclusions: Although to a lesser extent than their participation in oral care instruction of nursing staff, OHPs were involved in promoting and supporting oral ingestion at LTCI facilities.