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The Effectiveness of the Around- the-Clock In-Home Care System: Did It Prevent the Institutionalization of Frail Elderly?


Address correspondence to Sachiyo Murashima, Department of Community Health Nursing, Graduate School of Medicine, The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113–0033 Japan. E-mail:


Abstract  This study compares two communities in Japan from the perspective of community health care resources and their use by the elderly during 1992–98. In one community, programs of home care services for the elderly were reorganized to provide around-the-clock in-home nursing and home help services seven days a week (ACC). Official records were the major sources of data. Evidence from the analysis indicated that ACC might contribute to less use of institutionalization as an alternative to home care, even though, in some instances, institutionalization is the only appropriate alternative.