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advanced program implementation bed service goal cities community residents coordination among agencies coordination among health dependent variable diagram for predicting Elderly HWPE factors feasibility of implementation Financial Power Index Gold Plan Health and Welfare helper service goal helper service utilization HHSU higher home helper higher proportions home bed service home helper service hypothesized implementation process in-home indirect effect influences higher rates Japan Ministry Japanese levels medical service agencies Ministry of Health Moreover municipality types Nikkei nursing home bed older citizens older people influences older people living path coefficients Path Diagram perceived feasibility policy implementation population proportion of older proportions of short rates of older Research Questions scores of advanced service goal achievement short stay service significant predictor variables SSSU standardized coefficient stay service goal stay service utilization strongest predictor variable successful implementation towns Tsukada turn influences higher variance model villages welfare and medical welfare directors Welfare Plan welfare service