Abstract
Osaka City is the second largest government-designated city in Japan and has the largest number of welfare recipients in the country. In addition, Osaka City has many elderly people receiving public assistance. Care managers in the regional comprehensive support centers or the care management centers must provide care management for home-based care services of low-income elderly persons.
Care managers in Japan often operate care management centers with a small number of staff or by themselves, and there may be no one in the centers to consult with regarding difficult support cases. The regional comprehensive support centers sometimes provide logistical supports for care management centers. Many care managers find care management for low-income elderly persons difficult, and in such cases, the regional comprehensive support centers may provide logistical supports.
The objective of the present study is to examine the relationships between supports from inside and outside the workplace and the quality of care management practice for supporting the old low-income persons. In January and February 2021, we conducted a survey with self-administered and mailed questionnaires. In the survey, 800 care management centers and regional comprehensive support centers in Osaka City were randomly selected for the survey. Regarding COI disclosure, we have no financial relationships to disclose. All of the procedures of this study were approved by the Ethical Review Board of Human Subject Research at the BAIKA Women’s University. The present study is financially supported by the Japan Society of Care Management and the BAIKA Women’s University.
Structural Equation Modeling was performed to examine the relationships. The two independent variables as supports from inside the workplace were supports from administrators and colleagues, and the one independent variable as support from outside the workplace was support from the regional comprehensive support center. The regional comprehensive support center provides care management for low-income elderly persons, but also logistical support of care management centers' care mangers by providing support for difficult-to-support cases. The dependent variable was financial support and evaluation in care management practice to support low-income old adults.
The response rate was 15% (N=120). As a result, the goodness of fit in the structural equation modeling showed indicators of GFI = .977, AGFI = .940, CFI = .998, and RMSEA = .029, indicating that the model was statistically verified. The result of this study showed that the logistical support of the regional comprehensive support center was statistically associated with the quality of care management practice in the areas of financial support and evaluation.
The association between the independent and dependent variables (β = .26) was statistically significant but moderate, and the explanation rate (R2=.12) was not high. The regional comprehensive support center provides useful logistical support for a care manager in care management practice for the low-income elderly. However, the effectiveness cannot be clearly stated. Future tasks for the research include considering the content of supports provided by the regional comprehensive support centers and finding supports by other professionals.