Long-term Care Insurance Certification

LTCI care-need levels have been found to correlate with Barthel Index ADL scores in prior research. LTCI certification levels are generally re-evaluated every 6 to 12 months. LTCI assessment is conducted by a trained local government official who visits the home or hospital and uses a 74-item questionnaire. LTCI certification in Japan reflects disability and impairment in activities of daily living. Using a stricter endpoint of care need level 2 or above, or death, lower-activity groups still had higher risk than the exercise-and-walking group. After accounting for competing risk from mortality, lower physical activity groups had higher risk of LTCI certification.