TY - JOUR
T1 - Population ageing and wellbeing
T2 - Lessons from Japan's long-term care insurance policy
AU - Tamiya, Nanako
AU - Noguchi, Haruko
AU - Nishi, Akihiro
AU - Reich, Michael R.
AU - Ikegami, Naoki
AU - Hashimoto, Hideki
AU - Shibuya, Kenji
AU - Kawachi, Ichiro
AU - Campbell, John Creighton
N1 - Funding Information:
This work is in part funded by the generous support from the Bill & Melinda Gates Foundation and the China Medical Board, partly by a research grant from the Ministry of Health, Labour and Welfare (H22-seisaku-shitei-033), and partly by a research grant from Pfizer Health Research Foundation to NT. AN acknowledges support from the Nakajima Foundation in Japan for his academic endeavours at Harvard University. We thank Keizo Takemi, Thomas Inui, Yan Guo, Bong-Min Yang, and Hidehiko Ichimura for their valuable comments; Masayo Kashiwagi, Mikiya Sato, Li-Mei Chen, Hideto Takahashi, Gohei Kato, Pedro Olivares-Tirado, Tomoko Ito, and postgraduate students in the Department of Health Services Research, University of Tsukuba, for their academic support; Susan Hubbard for her technical edits; Hiyuko Fujita, Tomoko Suzuki, and Tadashi Yamamoto (Japan Center for International Exchange) for their administrative support; and Ruth Campbell for steady support. The views and opinions expressed by the independent authors in this report are provided in their personal capacity and are their sole responsibility.
PY - 2011
Y1 - 2011
N2 - Japan's population is ageing rapidly because of long life expectancy and a low birth rate, while traditional supports for elderly people are eroding. In response, the Japanese Government initiated mandatory public long-term care insurance (LTCI) in 2000, to help older people to lead more independent lives and to relieve the burdens of family carers. LTCI operates on social insurance principles, with benefi ts provided irrespective of income or family situation; it is unusually generous in terms of both coverage and benefi ts. Only services are provided, not cash allowances, and recipients can choose their services and providers. Analysis of national survey data before and after the programme started shows increased use of formal care at lower cost to households, with mixed results for the wellbeing of carers. Challenges to the success of the system include dissatisfaction with home-based care, provision of necessary support for family carers, and fi scal sustainability. Japan's strategy for long-term care could off er lessons for other nations.
AB - Japan's population is ageing rapidly because of long life expectancy and a low birth rate, while traditional supports for elderly people are eroding. In response, the Japanese Government initiated mandatory public long-term care insurance (LTCI) in 2000, to help older people to lead more independent lives and to relieve the burdens of family carers. LTCI operates on social insurance principles, with benefi ts provided irrespective of income or family situation; it is unusually generous in terms of both coverage and benefi ts. Only services are provided, not cash allowances, and recipients can choose their services and providers. Analysis of national survey data before and after the programme started shows increased use of formal care at lower cost to households, with mixed results for the wellbeing of carers. Challenges to the success of the system include dissatisfaction with home-based care, provision of necessary support for family carers, and fi scal sustainability. Japan's strategy for long-term care could off er lessons for other nations.
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U2 - 10.1016/S0140-6736(11)61176-8
DO - 10.1016/S0140-6736(11)61176-8
M3 - Review article
C2 - 21885099
AN - SCOPUS:80053264713
SN - 0140-6736
VL - 378
SP - 1183
EP - 1192
JO - The Lancet
JF - The Lancet
IS - 9797
ER -
