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June 8, 2026BMC Health Services ResearchOpen Access

Municipal implementation of community-based preventive programs during the COVID-19 pandemic and long-term care certification trends in Japan: a nationwide ecological analysis

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Authors

YKYujiro KurodaMOMasatsugu OruiYSYumi Shindo

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Overview

Ecological analysis assesses municipal program implementation's effect on care certification rates during COVID-19 in Japan, suggesting trends in care needs.

Key Points

  • This study investigates the relationship between the implementation of community-based preventive programs and trends in long-term care certification rates in Japan during and after the COVID-19 pandemic.
  • Nationwide ecological analysis linking municipal surveys from 2021 to LTC certification rates for FY2018–2023.
  • Comparison of full versus incomplete implementation across five domains: physical activity, social participation, cognitive training, nutrition, and health check-ups.
  • Use of difference-in-differences and event-study models, adjusted for various demographic and fiscal factors.
  • Full implementation of physical activity programs was linked to a smaller increase in LTCI certification rates during the pandemic compared to incomplete programs (-0.12 pp, 95% CI: -0.23 to -0.01).
  • A similar finding was observed for cognitive training programs (-0.14 pp, 95% CI: -0.25 to -0.03).
  • Sensitivity analyses indicated consistent directional patterns, though estimates were generally modest and less precise with additional adjustments.

Cite This Study

Kuroda et al. (2026) studied this question.

synapsesocial.com/papers/6a265cffad53cfb9357c643ehttps://doi.org/10.1186/s12913-026-14909-0
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