700 Section - Impact of the COVID-19 Pandemic on Rehabilitation Service Provision for Community-dwelling Older Adults with Disabilities: Interrupted Time Series Analysis Using a National Long-Term Care Insurance Database in Japan

Wednesday, May 20, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

KY

Kaori Yamaguchi, PhD

Research Fellow
Harvard TH Chan School of Public Health
Boston, Massachusetts, United States

Co-Author/Coautor(s)

YM

Yasuhiro Morii, PhD

Reseacher
National Institute of Public Health, Japan
Wako, Saitama, Japan
MA

Manabu Akahane, PhD

Director of the Department of Health and Welfare Services
National Institute of Public Health, Japan
Wako, Saitama, Japan

Corresponding Author/Autor a quien dirigir la corr(s)

IK

Ichiro Kawachi, PhD

Professor
Harvard TH Chan School of Public Health
Boston, Massachusetts, United States

Objectives : Health systems worldwide were disrupted by the COVID-19 pandemic and struggled to maintain essential services. However, the impact on the delivery of rehabilitation services remains unclear. This study sought to clarify how the pandemic affected rehabilitation service provision for community-dwelling older adults with disability in Japan.

Design: We used national long-term care (LTC) insurance data with complete nationwide service claims. The study population comprised all individuals aged ≥65 years certified as needing long-term care, ranging from mild to severe disabilities. Monthly nationwide data on rehabilitation, nursing care, and support for daily living—either at home or in day-care facilities—were obtained from publicly available sources for April 2016 to March 2024 (96 waves). To evaluate the impact of the COVID-19 pandemic, the period was divided into pre-, during-, and post-pandemic phases, with the pandemic defined as the national emergency period (April 2020–September 2021). Interrupted time series analysis with two interruption points was conducted.

Results: Statistically significant differences were observed across service types. Home-based rehabilitation increased pre-pandemic, declined sharply upon the onset of the pandemic, followed by a gradual recovery. Rehabilitation in day-care facilities declined before the pandemic, dropped sharply at its onset, followed by a non-significant pattern of recovery afterward. Support for daily living services increased pre-pandemic, declined at the onset, and gradually recovered without further level change. Home-based nursing care continued to rise throughout and showed no significant decline during the pandemic. Overall, all services except home-based nursing care experienced a significant initial drop during the pandemic, with recovery patterns varying by service type.

Conclusion: Changes in rehabilitation services at day-care facilities may have been influenced by both the pandemic and policy factors. In contrast, the stable trend in home-based nursing care may reflect reduced outpatient access during the pandemic. Further analyses are warranted to inform future preparedness efforts.