This study investigates the factors affecting difficulties and poor outcomes perceived by care managers (CMs) assisting older adults with financial difficulties in Japan’s insurance system. Based on the job demands-resources model, this study examines how CMs’ caseloads and case complexity (i.e., job demands), social support (i.e., job resources), and area socioeconomic status (SES) as structural factors influence these perceptions. In addition, this study sought to understand whether area SES affects difficulties and outcomes directly or indirectly through job demands and resource factors. The participants included 329 CMs from Tokyo. Findings revealed that caseloads impacted perceived difficulty, while case complexity significantly affected perceived challenges and outcomes. Variations in difficulties were directly associated with area SES, with no mediating factors. Addressing only the number of cases with financial issues proves inadequate for reducing the difficulties and negative outcomes CMs face. Care management practices that adequately navigate the intricacies of these cases should be developed. CMs in areas with lower SES encounter additional stressors. However, it remains unclear how area SES directly influences these difficulties. In addition, the effect sizes of these significant relationships were small to moderate; therefore, the practical significance of the results remains unclear.
Sugisawa et al. (Thu,) studied this question.